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Individual
KHALID AZZAM
Active
Individual
KHALID AZZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01075391A
IN
207X00000X
Orthopaedic Surgery Physician
6172
NE
207X00000X
Orthopaedic Surgery Physician
Primary
65384
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201319820
—
IN
Enumeration date
07/30/2009
Last updated
10/21/2019
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