Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 056116 | GA |
N | 207RA0201X | Internist - Allergy & Immunology | 27796 | SC |
NPI | 1104828250 |
---|---|
Provider Name | Dr. Wasil Khan |
First Address | Savannah, GA 31406-3928 |
Second Address | Savannah, GA 31406-3928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 05/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I34430 | (02) |