Provider Demographics
NPI:1861846560
Name:CHANGAL, KHALID HAMID (MD)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:HAMID
Last Name:CHANGAL
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 1:801 5TH ST
Mailing Address - Street 2:MERCYONE SIOUXLAND INTERVENTIONAL CARDIOLOGY
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51101
Mailing Address - Country:US
Mailing Address - Phone:712-279-2010
Mailing Address - Fax:
Practice Address - Street 1:801 5TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1326
Practice Address - Country:US
Practice Address - Phone:712-279-2010
Practice Address - Fax:419-383-3041
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2023-07-11
Deactivation Date:2016-12-14
Deactivation Code:
Reactivation Date:2017-01-11
Provider Licenses
StateLicense IDTaxonomies
IAMD-51149207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology