Provider Demographics
NPI:1780681767
Name:KHANBHAI, KARIM Z (MD)
Entity Type:Individual
Prefix:DR
First Name:KARIM
Middle Name:Z
Last Name:KHANBHAI
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:PO BOX 1454
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-0710
Mailing Address - Country:US
Mailing Address - Phone:401-381-0066
Mailing Address - Fax:401-381-0068
Practice Address - Street 1:37 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-4927
Practice Address - Country:US
Practice Address - Phone:401-381-0066
Practice Address - Fax:401-381-0068
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI10009208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIKK59017Medicaid
RIKK59017Medicaid
G89477Medicare UPIN