Provider Demographics
NPI:1730372541
Name:PERVAIZ, KHURRAM (MD)
Entity type:Individual
Prefix:
First Name:KHURRAM
Middle Name:
Last Name:PERVAIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KHURRAM
Other - Middle Name:
Other - Last Name:PERVAIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:910 FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4516
Mailing Address - Country:US
Mailing Address - Phone:410-644-1880
Mailing Address - Fax:410-644-6048
Practice Address - Street 1:910 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4516
Practice Address - Country:US
Practice Address - Phone:410-644-1880
Practice Address - Fax:410-644-6048
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0072127207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery