Individual
MUSTAFA S. KHALIQI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1590
(410) 328-7943
(410) 328-3494
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-8040
(443) 462-3514
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D90755
MD
208M00000X
Hospitalist Physician
Primary
D90755
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021639000
—
FL
01
—
JC208Z
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/07/2014
Last updated
03/22/2021
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