Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 15427R | LA |
N | 207PP0204X | Pediatric Emergency Physician | 15427R | LA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 15427R | LA |
N | 207QA0505X | Family Doctor - Adult Medicine | 15427R | LA |
N | 208000000X | Pediatrician | 15427R | LA |
Y | 208000000X | Pediatrician | C1-0008136 | DE |
N | 208000000X | Pediatrician | D0064698 | MD |
N | 2080A0000X | Adolescent Medicine | C1-0008136 | DE |
N | 2080N0001X | Neonatal-Perinatal Doctor | D0064698 | MD |
N | 2080P0207X | Pediatric Hematology-Oncologist | 15427R | LA |
N | 2080P0207X | Pediatric Hematology-Oncologist | D0064698 | MD |
NPI | 1639113285 |
---|---|
Provider Name | Dr. Mohammad Ali Khan |
First Address | Newark, DE 19711-5235 |
Second Address | Elkton, MD 21921-5906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 20/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1000040965 | (05) | DE |