Provider Demographics
NPI:1780032813
Name:ALKHATIB, SUEHYB GHAZI (MD)
Entity Type:Individual
Prefix:
First Name:SUEHYB
Middle Name:GHAZI
Last Name:ALKHATIB
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 1:827 LINDEN AVENUE
Mailing Address - Street 2:PROGRAM OFFICE ADDRESS
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-225-8790
Mailing Address - Fax:
Practice Address - Street 1:827 LINDEN AVENUE
Practice Address - Street 2:PROGRAM OFFICE ADDRESS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:703-909-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4655442085N0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology