Provider Demographics
NPI:1679536338
Name:KHALID, MUHAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:
Last Name:KHALID
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 1:1820 SAINT CHARLES AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5268
Mailing Address - Country:US
Mailing Address - Phone:504-914-4851
Mailing Address - Fax:213-291-9169
Practice Address - Street 1:1820 SAINT CHARLES AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5268
Practice Address - Country:US
Practice Address - Phone:504-523-9691
Practice Address - Fax:504-523-9694
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5690207RC0000X
LA13115R207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1579696Medicaid
LA1579696Medicaid
LA4E650Medicare ID - Type Unspecified