Individual
DR. NAGWA KHADR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2120 SARNO RD, MELBOURNE, FL 32935-3084
(321) 241-6800
(321) 241-6890
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301060896
MI
208000000X
Pediatrics Physician
50618
CT
208000000X
Pediatrics Physician
MD453558
PA
208000000X
Pediatrics Physician
Primary
ME161425
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118109400
—
FL
01
—
350D410030
BCBSM BCN COM BLUE CHOICE
MI
05
—
4290947
—
MI
05
—
4956925
—
MI
Enumeration date
05/04/2006
Last updated
11/08/2023
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