Basic Information
| Provider Information | |||||||||
| NPI: | 1295902021 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHALID | ||||||||
| FirstName: | SOHAIB | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3495 PIEDMONT RD NE | ||||||||
| Address2: | NINE PIEDMONT CENTER | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303051717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4045045678 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 CRESCENT CENTER PKWY | ||||||||
| Address2: | KAISER PERMANENTE CRESCENT MEDICAL CENTER | ||||||||
| City: | TUCKER | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300847047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704963414 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2008 | ||||||||
| LastUpdateDate: | 01/10/2022 | ||||||||
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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 | 207Q00000X | 4301091907 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 076487 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.