Provider Demographics
NPI:1720309248
Name:ALSHERBINI, KHALID (MD)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:
Last Name:ALSHERBINI
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:PO BOX 1000
Mailing Address - Street 2:DEPT 457
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0001
Mailing Address - Country:US
Mailing Address - Phone:901-516-7788
Mailing Address - Fax:901-387-5153
Practice Address - Street 1:1265 UNION AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3415
Practice Address - Country:US
Practice Address - Phone:901-516-7788
Practice Address - Fax:901-387-5153
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ714352084A2900X
TN523632084N0400X
OH35.1217682084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6046373OtherBCBS
AR210721001Medicaid
MS03004762Medicaid
TNQ014396Medicaid
AR210721001Medicaid