Provider Demographics
NPI:1851829337
Name:KHALID, MUHAMMAD UMAR (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD UMAR
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 1:1717 E 9TH ST APT 1904
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2821
Mailing Address - Country:US
Mailing Address - Phone:330-941-9412
Mailing Address - Fax:
Practice Address - Street 1:1415 PORTLAND AVENUE
Practice Address - Street 2:MEDICAL OFFICE BUILDING #590
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:44195-1009
Practice Address - Country:US
Practice Address - Phone:585-922-4193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 390200000X
IAMD-47638208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program