Provider Demographics
NPI:1740162312
Name:ALKHALAILA, MOHANAD KHALED ABED ALRAHMAN (MD)
Entity type:Individual
Prefix:
First Name:MOHANAD
Middle Name:KHALED ABED ALRAHMAN
Last Name:ALKHALAILA
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 1:824 MAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-4478
Mailing Address - Country:US
Mailing Address - Phone:610-983-1133
Mailing Address - Fax:
Practice Address - Street 1:824 MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4478
Practice Address - Country:US
Practice Address - Phone:610-983-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT234998390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program