# KHALED RIAD KHASAWNEH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1356370910
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | E-4692 | AR | — |
| 207RP1001X | Pulmonary Disease Physician | E-4692 | AR | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | E-4692 | AR | Yes |

## Other

- **Enumeration date:** 07/03/2006
- **Last updated:** 04/20/2016

## 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 |