Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | D42194 | MD |
N | 207KA0200X | Allergist | D42194 | MD |
NPI | 1114100583 |
---|---|
Provider Name | Dr. Shalla H Khan |
First Address | Gaithersburg, MD 20878-1678 |
Second Address | Gaithersburg, MD 20878-1678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2007 |
Last Update Date | 07/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F40435 | (02) | MD |