Provider Demographics
NPI:1851375489
Name:RIKABI, KHALED A (MD)
Entity type:Individual
Prefix:DR
First Name:KHALED
Middle Name:A
Last Name:RIKABI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:101 GREENFIELD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3171
Mailing Address - Country:US
Mailing Address - Phone:678-845-7300
Mailing Address - Fax:678-845-7301
Practice Address - Street 1:101 GREENFIELD DR STE 100
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-3171
Practice Address - Country:US
Practice Address - Phone:678-845-7300
Practice Address - Fax:678-845-7301
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143583207RI0200X
MS15692207RI0200X
MEMD25396207RI0200X
GA78648207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03238237Medicaid
MS440000022Medicare ID - Type Unspecified
F05781Medicare UPIN