Provider Demographics
NPI:1952349334
Name:KHAWAJA, NAZIR AHMAD (MD)
Entity Type:Individual
Prefix:DR
First Name:NAZIR
Middle Name:AHMAD
Last Name:KHAWAJA
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 1:4124 HIGHWAY 278 NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2494
Mailing Address - Country:US
Mailing Address - Phone:770-784-1172
Mailing Address - Fax:
Practice Address - Street 1:4124 HIGHWAY 278 NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2494
Practice Address - Country:US
Practice Address - Phone:770-784-1172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025778207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000282499VMedicaid
D29922Medicare UPIN
GA000282499QMedicaid