Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RP1001X | Pulmonary Disease | 57587 | MN |
Y | 207RP1001X | Pulmonary Disease | 60691 | WI |
N | 207RS0012X | Sleep Medicine | 60691 | WI |
NPI | 1053558676 |
---|---|
Provider Name | Muhammad Talha Khan |
First Address | Saint Croix Falls, WI 54024-4117 |
Second Address | Saint Croix Falls, WI 54024-4117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2009 |
Last Update Date | 11/11/2020 |