Provider Demographics
NPI:1144472432
Name:KHALID, SAIMA (MD)
Entity type:Individual
Prefix:
First Name:SAIMA
Middle Name:
Last Name:KHALID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 E OREGON RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9299
Mailing Address - Country:US
Mailing Address - Phone:717-569-7670
Mailing Address - Fax:717-581-3896
Practice Address - Street 1:1143 E OREGON RD STE 101
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-9299
Practice Address - Country:US
Practice Address - Phone:717-569-7670
Practice Address - Fax:717-581-3896
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4757512083X0100X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008002934Medicaid