Provider Demographics
NPI:1336674100
Name:KHALIL, NABIHA (MD)
Entity Type:Individual
Prefix:MISS
First Name:NABIHA
Middle Name:
Last Name:KHALIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 ROSS CLARK CIR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-3022
Mailing Address - Country:US
Mailing Address - Phone:334-793-8111
Mailing Address - Fax:
Practice Address - Street 1:350 W THOMAS ROAD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013
Practice Address - Country:US
Practice Address - Phone:602-406-3540
Practice Address - Fax:602-406-3540
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2020-10-14
Deactivation Date:2017-12-04
Deactivation Code:
Reactivation Date:2018-01-31
Provider Licenses
StateLicense IDTaxonomies
ALMD.41371208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist