Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | D0023240 | MD |
NPI | 1386619583 |
---|---|
Provider Name | Dr. Hidayat Khan |
First Address | Ellicott City, MD 21042-1217 |
Second Address | Frederick, MD 21701-4564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 29/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D72201 | (02) | MD |
K347 | BLUECROSS BLUESHIELD OF M (01) | MD |