Basic Information
| Provider Information | |||||||||
| NPI: | 1295744985 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ABRAR U KHAN MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 E 86TH AVE | ||||||||
| Address2: | PO BOX 10645 | ||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464106382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197691670 | ||||||||
| FaxNumber: | 2197386714 | ||||||||
| Practice Location | |||||||||
| Address1: | 8701 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464107035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197691670 | ||||||||
| FaxNumber: | 2197386714 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 06/13/2008 | ||||||||
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| AuthorizedOfficialLastName: | KHAN | ||||||||
| AuthorizedOfficialFirstName: | ABRAR | ||||||||
| AuthorizedOfficialMiddleName: | U | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2197691670 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | 01052867 | IN | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200373430A | 05 | IN | MEDICAID | 200343430B | 05 | IN | MEDICAID |