Individual
KHALIL J HAIDERZAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 N WESTWOOD BLVD, JOHN J PERSHING VAMC, POPLAR BLUFF, MO 63901-3318
(573) 778-4441
Mailing address
1500 N WESTWOOD BLVD, JOHN J PERSHING VAMC, POPLAR BLUFF, MO 63901-3318
(573) 778-4441
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19187
NE
Other
Enumeration date
09/17/2006
Last updated
01/24/2014
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