Basic Information
| Provider Information | |||||||||
| NPI: | 1194926063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHIRBAT | ||||||||
| FirstName: | ROHIT | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8909 OLD BRANCH AVE | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207352528 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018687274 | ||||||||
| FaxNumber: | 2024030508 | ||||||||
| Practice Location | |||||||||
| Address1: | 801 TOLL HOUSE AVE STE B2 | ||||||||
| Address2: | |||||||||
| City: | FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217016110 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2405759032 | ||||||||
| FaxNumber: | 2405759042 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 12/30/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 059444 | GA | N | Other Service Providers | Specialist | 207RC0200X | D67210 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 059444 | 01 | GA | GEORIGA LICENSE | OTHER | 414695600 | 05 | MD | MEDICAID |