Provider Demographics
NPI:1891995510
Name:ATHAR, KHALID (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALID
Middle Name:
Last Name:ATHAR
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 1:1912 SEPTEMBER CT
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3313
Mailing Address - Country:US
Mailing Address - Phone:202-460-0988
Mailing Address - Fax:
Practice Address - Street 1:541 SUNSET LN STE 201
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3979
Practice Address - Country:US
Practice Address - Phone:540-829-0700
Practice Address - Fax:540-829-8191
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243070207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101243070OtherVIRGINIA LICENSE
VA1891995510Medicaid