Provider Demographics
NPI:1194987677
Name:KASAJI, MOHAMMAD KHALIL (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:KHALIL
Last Name:KASAJI
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:PO BOX 601843
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5820 E WT HARRIS BLVD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3542
Practice Address - Country:US
Practice Address - Phone:704-548-7962
Practice Address - Fax:704-631-3431
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271425207Q00000X
NC2018-02583207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine