Provider Demographics
NPI:1194926063
Name:KHIRBAT, ROHIT (MD)
Entity type:Individual
Prefix:
First Name:ROHIT
Middle Name:
Last Name:KHIRBAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8909 OLD BRANCH AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2528
Mailing Address - Country:US
Mailing Address - Phone:301-868-7274
Mailing Address - Fax:202-403-0508
Practice Address - Street 1:801 TOLL HOUSE AVE STE B2
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6110
Practice Address - Country:US
Practice Address - Phone:240-575-9032
Practice Address - Fax:240-575-9042
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059444174400000X
MDD67210207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA059444OtherGEORIGA LICENSE
MD414695600Medicaid
MD130450ZAHBMedicare PIN