Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 2009035015 | MO |
Y | 2086S0105X | Surgery of the Hand | 2009035015 | MO |
NPI | 1780839902 |
---|---|
Provider Name | Mohamed Khalid |
First Address | Columbia, MO 65205-7687 |
Second Address | Columbia, MO 65212-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2008 |
Last Update Date | 20/04/2011 |