Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2013-00923 | NC |
Y | 208600000X | Surgeon | 2013-00923 | NC |
N | 208200000X | Surgeon | P6658 | TX |
N | 208600000X | Surgeon | P6658 | TX |
N | 208200000X | Surgeon | LL28527 | SC |
N | 208600000X | Surgeon | LL28527 | SC |
N | 2086S0122X | Plastic and Reconstructive Surgery | 2013-00923 | NC |
N | 2086S0122X | Plastic and Reconstructive Surgery | P6658 | TX |
NPI | 1205035102 |
---|---|
Provider Name | Dr. Phillip David Khan |
First Address | Charlotte, NC 28260-0447 |
Second Address | Southport, NC 28461-2674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 25/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NCC940B | (02) | NC |