Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | D72236 | MD |
NPI | 1467470567 |
---|---|
Provider Name | Ahsan S Khan |
First Address | Sykesville, MD 21784-5600 |
Second Address | Sykesville, MD 21784-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D72236 | (02) | MD |