Provider Demographics
NPI:1902875834
Name:WESTMINSTER INTERNAL MEDICINE ASSOCIATION
Entity type:Organization
Organization Name:WESTMINSTER INTERNAL MEDICINE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALIL
Authorized Official - Middle Name:
Authorized Official - Last Name:FREIJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-848-7117
Mailing Address - Street 1:295 STONER AVE
Mailing Address - Street 2:SUITE 305-307
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5698
Mailing Address - Country:US
Mailing Address - Phone:410-848-7117
Mailing Address - Fax:410-857-8575
Practice Address - Street 1:295 STONER AVE
Practice Address - Street 2:SUITE 305-307
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5698
Practice Address - Country:US
Practice Address - Phone:410-848-7117
Practice Address - Fax:410-857-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD585LMedicare ID - Type Unspecified