Basic Information
| Provider Information | |||||||||
| NPI: | 1366456824 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RAZULLAH KHWAJA, M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 190 | ||||||||
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| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219220190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103984679 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 COLONIAL WAY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | RISING SUN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219112283 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103984679 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 10/11/2007 | ||||||||
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| AuthorizedOfficialLastName: | CORNELL | ||||||||
| AuthorizedOfficialFirstName: | JESSICA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING | ||||||||
| AuthorizedOfficialTelephone: | 4103984679 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0105X | D38804 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
No ID Information.