Basic Information
| Provider Information | |||||||||
| NPI: | 1497700439 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | MASHUKUR | ||||||||
| MiddleName: | RAHMAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 LOCUST ST | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152195114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122327388 | ||||||||
| FaxNumber: | 4129379221 | ||||||||
| Practice Location | |||||||||
| Address1: | 680 ANDERSEN DR | ||||||||
| Address2: | FOSTER PLAZA 10 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152202759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129378887 | ||||||||
| FaxNumber: | 4129379221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 07/24/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD 073059L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | C20645 | 01 | PALMETTO GBA MEDICARE | OTHER | H54796 | 01 | CAN HEALTH PARTNERS | OTHER | H54796 | 01 | MEDICARE PQHC UGS | OTHER | H54796 | 01 | AETNA HEALTH PLANS | OTHER | H54796 | 01 | ACORDIA NATIONAL | OTHER | H54796 | 01 | CIGNA PRO | OTHER | H54796 | 01 | HEALTH ASSURANCE PLAN | OTHER | H54796 | 01 | NCAS | OTHER | H54796 | 01 | RETIRED RAILROAD MEDICARE | OTHER | H54796 | 01 | UNITED HEALTHCARE | OTHER | K385HT | 01 | CAREFIRST | OTHER | 054721FNN | 01 | PENNSYLVANIA MEDICARE | OTHER | H43796 | 01 | GROUP BENEFIT SERVICES | OTHER | 1327910 | 01 | PENNSYLVANIA PERSONAL | OTHER | 3810001526 | 01 | UNISYS | OTHER | 89715 | 01 | MID ATLANTIC MEDICAL SERV | OTHER |