Provider Demographics
NPI:1356900153
Name:HAROON KHALID MD PC
Entity type:Organization
Organization Name:HAROON KHALID MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER AND CODER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:NEDZELSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-228-1918
Mailing Address - Street 1:200 NE 54TH ST UNIT 120
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4338
Mailing Address - Country:US
Mailing Address - Phone:816-453-7771
Mailing Address - Fax:816-452-7980
Practice Address - Street 1:200 NE 54TH ST UNIT 120
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4338
Practice Address - Country:US
Practice Address - Phone:816-453-7771
Practice Address - Fax:816-452-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
13735150OtherCAQH