Provider Demographics
NPI:1902082795
Name:GONDAL, MUHAMMAD KHALID (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:KHALID
Last Name:GONDAL
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 1:715 MALL RING CIR STE 202
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6667
Mailing Address - Country:US
Mailing Address - Phone:702-483-5092
Mailing Address - Fax:
Practice Address - Street 1:715 MALL RING CIR STE 202
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6667
Practice Address - Country:US
Practice Address - Phone:702-483-5092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16756207RS0012X, 207RP1001X, 207RS0012X
KY43232207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100097570Medicaid
KYP01344567OtherRAILROAD MEDICARE
KYP01344567OtherRAILROAD MEDICARE
KYK098202Medicare PIN