Provider Demographics
NPI:1699809715
Name:MUHAMMAD A. KHALID, DPM,PC
Entity Type:Organization
Organization Name:MUHAMMAD A. KHALID, DPM,PC
Other - Org Name:ANACOSTIA FOOT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHALID
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:202-889-6020
Mailing Address - Street 1:2041 MARTIN LUTHER KING JR AVE SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7024
Mailing Address - Country:US
Mailing Address - Phone:202-889-6020
Mailing Address - Fax:202-889-6021
Practice Address - Street 1:2041 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:SUITE 103
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7024
Practice Address - Country:US
Practice Address - Phone:202-889-6020
Practice Address - Fax:202-889-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCP0478213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC12107OtherCHARTERED HEALTH PLAN
DC000594594OtherAPWU
DC08508OtherAMERIGROUP
DC4151OtherBLUE CROSS BLUE SHIELD
DC246484MD2OtherM.D. IPA
DC026584500Medicaid
DC=========OtherUNITED HEALTH CARE
DC=========OtherEIN #
DC026584500Medicaid
DC246484MD2OtherM.D. IPA
DC=========OtherAETNA HEALTH PLAN
DC08508OtherAMERIGROUP
DC=========OtherMAMSI
DC480006985Medicare ID - Type UnspecifiedRAILROAD MEDICARE
DC08508OtherAMERIGROUP
DC=========OtherMAMSI