Provider Demographics
NPI:1720058928
Name:KHALID, MUHAMMAD A (DPM)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:A
Last Name:KHALID
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 MARTIN LUTHER KING JR AVE SE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7024
Mailing Address - Country:US
Mailing Address - Phone:202-889-6020
Mailing Address - Fax:202-889-6021
Practice Address - Street 1:2041 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:SUITE 103
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7024
Practice Address - Country:US
Practice Address - Phone:202-889-6020
Practice Address - Fax:202-889-6021
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO478213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC60167058OtherAMERIHEALTH CARITAS DISTRICT OF COLUMBIA
DC026584500Medicaid
DC246484OtherM.D. IPA
DC000594594OtherAPWU
DC60167058OtherAMERIHEALTH CARITAS DISTRICT OF COLUMBIA
52-1940413OtherTAX ID NUMBER