Basic Information
Provider Information | |||||||||
NPI: | 1295117042 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | KHAWAJA | ||||||||
FirstName: | MUHAMMAD HANEEF | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 8117 PRESTON RD STE 800 | ||||||||
Address2: |   | ||||||||
City: | DALLAS | ||||||||
State: | TX | ||||||||
PostalCode: | 752256328 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2146669531 | ||||||||
FaxNumber: | 9725599146 | ||||||||
Practice Location | |||||||||
Address1: | 640 S STATE ST | ||||||||
Address2: |   | ||||||||
City: | DOVER | ||||||||
State: | DE | ||||||||
PostalCode: | 199013530 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3027447581 | ||||||||
FaxNumber: | 3027447332 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/28/2015 | ||||||||
LastUpdateDate: | 07/05/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/05/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C1-0012793 | DE | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.