Provider Demographics
NPI:1982047932
Name:BAOSMAN, KHALID BIN AHMED (MD)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:BIN AHMED
Last Name:BAOSMAN
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 1:2400 HOSPITAL DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-2385
Mailing Address - Country:US
Mailing Address - Phone:318-212-7990
Mailing Address - Fax:318-212-7995
Practice Address - Street 1:2400 HOSPITAL DR
Practice Address - Street 2:SUITE 130
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-2385
Practice Address - Country:US
Practice Address - Phone:318-212-7990
Practice Address - Fax:318-212-7995
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA303315207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine