Provider Demographics
NPI:1851703938
Name:KHALID, MOHAMMED ASAD (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:ASAD
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 1:357 GENESEE ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2658
Mailing Address - Country:US
Mailing Address - Phone:315-363-4651
Mailing Address - Fax:315-363-2821
Practice Address - Street 1:357 GENESEE ST
Practice Address - Street 2:SUITE #2
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2658
Practice Address - Country:US
Practice Address - Phone:315-363-4651
Practice Address - Fax:315-363-2821
Is Sole Proprietor?:No
Enumeration Date:2014-05-23
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10050665207X00000X
LA320437207X00000X
NY306879207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06116898Medicaid