Provider Demographics
NPI:1053327445
Name:KHANIFAR, AZIZ ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:AZIZ
Middle Name:ALEXANDER
Last Name:KHANIFAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7501 GREENWAY CENTER DR # 300
Mailing Address - Street 2:RETINA GROUP OF WASHINGTON
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-441-4577
Mailing Address - Fax:301-474-7182
Practice Address - Street 1:8630 FENTON ST STE 1104
Practice Address - Street 2:RETINA GROUP OF WASHINGTON
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3836
Practice Address - Country:US
Practice Address - Phone:301-495-2357
Practice Address - Fax:301-495-2359
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-04-09
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Provider Licenses
StateLicense IDTaxonomies
DCMD038882207W00000X, 207WX0107X
MDD71222207W00000X, 207WX0107X
VA0101239747207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1053327445Medicaid
MD513401300Medicaid
DC054078300Medicaid
DC054078300Medicaid