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Individual
KHALED RIAD KHASAWNEH
Active
Individual
KHALED RIAD KHASAWNEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
E-4692
AR
207RP1001X
Pulmonary Disease Physician
E-4692
AR
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
E-4692
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101245603
STATE LICENSE
VA
05
—
1356370910
—
VA
05
—
7100076780
—
KY
01
—
C10456
TRAILBLAZER
VA
01
—
E-4692
LICENSE NUMBER
AR
01
—
P00733560
RAILROAD MEDICARE
VA
Enumeration date
07/03/2006
Last updated
04/20/2016
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