Provider Demographics
NPI:1326085374
Name:HAMID, KHAWAJA K (MD)
Entity Type:Individual
Prefix:
First Name:KHAWAJA
Middle Name:K
Last Name:HAMID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5129
Mailing Address - Fax:740-446-5622
Practice Address - Street 1:170 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1539
Practice Address - Country:US
Practice Address - Phone:740-446-5129
Practice Address - Fax:740-446-5622
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-0832207RX0202X
WV21366207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH084809638OtherTRI CARE
OH0545753Medicaid
830007568OtherRR MEDICARE
000000205917OtherANTHEM BCBS
WV0082093000Medicaid
OH310917085161OtherCARESOURCE MEDICAID
OH000000185150OtherUNISON MEDICAID
OH0545753OtherMOLINA MEDICAID
001714128OtherMOUNTAIN STATE BCBS
001714128OtherMOUNTAIN STATE BCBS
830007568OtherRR MEDICARE
OH000000185150OtherUNISON MEDICAID