Provider Demographics
NPI:1528141124
Name:KHALIL, AHLAM N (MD,FACOG)
Entity type:Individual
Prefix:
First Name:AHLAM
Middle Name:N
Last Name:KHALIL
Suffix:
Gender:F
Credentials:MD,FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4239 PENN AVE
Mailing Address - Street 2:STE 9
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-1373
Mailing Address - Country:US
Mailing Address - Phone:610-678-9010
Mailing Address - Fax:610-678-5590
Practice Address - Street 1:145 N 6TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3501
Practice Address - Country:US
Practice Address - Phone:610-764-1314
Practice Address - Fax:610-678-5590
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047433L207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014213390001Medicaid
PAG13914Medicare UPIN