Provider Demographics
NPI:1578247680
Name:KHALID, ANAM
Entity Type:Individual
Prefix:
First Name:ANAM
Middle Name:
Last Name:KHALID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9411 BALLARD GREEN DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5915
Mailing Address - Country:US
Mailing Address - Phone:510-945-9076
Mailing Address - Fax:
Practice Address - Street 1:8063 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2966
Practice Address - Country:US
Practice Address - Phone:410-995-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD18025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist