Provider Demographics
NPI:1245478874
Name:AL-KHADRA, AYMAN S (MD)
Entity type:Individual
Prefix:
First Name:AYMAN
Middle Name:S
Last Name:AL-KHADRA
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:P.O. BOX 7897
Mailing Address - Street 2:X-982
Mailing Address - City:RIYADH
Mailing Address - State:SA
Mailing Address - Zip Code:11159
Mailing Address - Country:SA
Mailing Address - Phone:9661-478-3000
Mailing Address - Fax:
Practice Address - Street 1:RIYADH MILITARY HOSP X-982
Practice Address - Street 2:
Practice Address - City:RIYADH
Practice Address - State:SA
Practice Address - Zip Code:11159
Practice Address - Country:SA
Practice Address - Phone:9661-478-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine