Individual provider Active NPI

Haris Khwaja, M.D, PHD, FRCS

  • Student in an Organized Health Care Education/Training Program
  • Cleveland, OH
National Provider Identifier
1104056696
Registry record updated Jul 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
57.015928 Issued in OH
Practice address
9500 Euclid Ave
Desk a-53 C/O Nada Johnson, Cleveland Clinic
Cleveland, OH 44195
Phone
(216) 445-9863
Fax
(216) 445-1636
NPI assigned
Jul 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 57.015928 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Desk a-53 C/O Nada Johnson, Cleveland Clinic
Cleveland, OH 44195

Mailing address

30 Severance Cir Apt 604
Kensington Place
Cleveland Heights, OH 44118-5504
Phone (216) 647-6961

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
57.015928OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248048000000",
    "number": "1104056696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SEVERANCE CIR APT 604",
            "address_2": "KENSINGTON PLACE",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441185504",
            "telephone_number": "216-647-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DESK A-53 C/O NADA JOHNSON, CLEVELAND CLINIC",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44195",
            "telephone_number": "216-445-9863",
            "fax_number": "216-445-1636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHWAJA",
        "first_name": "HARIS",
        "name_prefix": "Dr.",
        "credential": "M.D, PHD, FRCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-20",
        "last_updated": "2009-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "57.015928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.