Provider Demographics
NPI:1942628656
Name:TUWAIRQI, KHALED (MBBS)
Entity Type:Individual
Prefix:
First Name:KHALED
Middle Name:
Last Name:TUWAIRQI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 ROGATE CIR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-5701
Mailing Address - Country:US
Mailing Address - Phone:571-212-9430
Mailing Address - Fax:
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:ROOM 4C104
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-581-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program