Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RX0202X | Medical Oncology | 65708 | WI |
N | 207T00000X | Neurosurgeon | 0101239547 | VA |
N | 2080P0207X | Pediatric Hematology-Oncologist | 0101239547 | VA |
N | 2080P0207X | Pediatric Hematology-Oncologist | 65708 | WI |
Y | 2084N0400X | Neurologist | 65708 | WI |
NPI | 1003836107 |
---|---|
Provider Name | Dr. Asadullah Khan |
First Address | Milwaukee, WI 53215 |
Second Address | Milwaukee, WI 53215-3669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 26/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010268087 | (05) | VA |
1003836107 | (05) | WI |