Provider Demographics
NPI:1881213007
Name:AZIZ, KHALED (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KHALED
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231
Mailing Address - Country:US
Mailing Address - Phone:410-955-7390
Mailing Address - Fax:
Practice Address - Street 1:401 N BROADWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231
Practice Address - Country:US
Practice Address - Phone:401-955-7390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program