Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D25393 | MD |
NPI | 1023088358 |
---|---|
Provider Name | Karim Khatibi |
First Address | Glen Burnie, MD 21061-5803 |
Second Address | Glen Burnie, MD 21061-5803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 31/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160007795 | MEDICARE RAILROAD (01) | MD |
772071800 | (05) | MD |
B70032 | (02) |