Khalifa Al-Sulaiti, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Richmond, VA
NPI 1679304802 · NPPES record last updated Jun 21, 2026
Key facts
- NPI
- 1679304802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- License
- 0116039393 (VA)
- Practice address
- 417 N 11TH St
Richmond, VA 23298-5024 - Phone
- (804) 828-8786
- Fax
- (804) 828-5466
- NPI assigned
- Aug 9, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240911003806 | VA | Order and Referring Only - Family Practice |
2062952401 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0116039393 | VA | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0116039393 | VA | Yes |
Addresses
Primary practice location
417 N 11TH St
Richmond, VA 23298-5024
Mailing address
PO Box 980257
Richmond, VA 23298-0257
Phone (804) 828-9783
Other practice location 1
1755 N Mecklenburg Ave
South Hill, VA 23970-4080
Phone (434) 584-5540
Other providers in Richmond, VA
- Ahmad Al-Husseini
- Uesser Hisham Mobder Al-Janaby
- Cheryl S. Al-Mateen
- Ali Omar Al-Saadoon
- Ahmad A Al-Sahli
- Emily Aladnani
- Jenan M a S a Alahmad
- Ahmad M H M Alali
- Arif Syed Alam
- Umar Naseef Bin Alam
All providers in Richmond, VA · Student in an Organized Health Care Education/Training Program in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.