Provider Demographics
NPI:1407122567
Name:SHEBA KHALID MD, LLC.
Entity Type:Organization
Organization Name:SHEBA KHALID MD, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEBA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-663-3000
Mailing Address - Street 1:10965 GRANADA LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1469
Mailing Address - Country:US
Mailing Address - Phone:913-663-3000
Mailing Address - Fax:913-663-2405
Practice Address - Street 1:10965 GRANADA LN
Practice Address - Street 2:SUITE 102
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1469
Practice Address - Country:US
Practice Address - Phone:913-663-3000
Practice Address - Fax:913-663-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0.0000373Medicare UPIN