Individual
DR. KHALID PUTHAWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
602 S ATWOOD RD, SUITE 206, BEL AIR, MD 21014-4172
(410) 638-7544
(410) 638-2221
Mailing address
501 FAIRMOUNT AVENUE, SUITE 103, TOWSON, MD 21286
(410) 494-7921
(410) 902-8247
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101239692
VA
207RP1001X
Pulmonary Disease Physician
Primary
0101239692
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020483ZB6F
MEDICARE PTAN
MD
05
—
417678200
—
MD
Enumeration date
05/26/2006
Last updated
06/23/2017
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