Individual
SHAZIB N. KHAWAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 DIXIE ST, SUITE 401, CARROLLTON, GA 30117-3818
(770) 836-9326
Mailing address
119 AMBULANCE DR 202, CARROLLTON, GA 30117-3857
(770) 838-8710
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
058888
GA
207RC0000X
Cardiovascular Disease Physician
25860
AL
207RI0011X
Interventional Cardiology Physician
Primary
058888
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009949425
—
AL
05
—
08537330
—
MS
01
—
2510927
UNITED HEALTH CARE
AL
05
—
269454900
—
FL
01
—
51521327
BLUE CROSS
AL
Enumeration date
05/20/2006
Last updated
08/04/2015
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