Basic Information
| Provider Information | |||||||||
| NPI: | 1457329005 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | MOHAMMED | ||||||||
| MiddleName: | N. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD | ||||||||
| Address2: | RUSSELL MORGAN BLDG., 3RD FLOOR | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104645600 | ||||||||
| FaxNumber: | 4104355367 | ||||||||
| Practice Location | |||||||||
| Address1: | 5601 LOCH RAVEN BLVD | ||||||||
| Address2: | RUSSELL MORGAN BLDG., 3RD FLOOR | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212392905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104645600 | ||||||||
| FaxNumber: | 4104355367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D25391 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.