Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | 22062 | WV |
Y | 207Q00000X | Family Doctor | 0101249245 | VA |
N | 207Q00000X | Family Doctor | 22062 | WV |
NPI | 1073593885 |
---|---|
Provider Name | Dr. Yusuf Hameed Khan |
First Address | Ashburn, VA 20148 |
Second Address | Reston, VA 20190 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 15/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810004432 | (05) | WV |
I49205 | (02) | WV |