Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 01049317A | IN |
NPI | 1003981929 |
---|---|
Provider Name | Rizwan N Khan |
First Address | Indianapolis, IN 46268-3129 |
Second Address | Salem, IN 47167-2304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2006 |
Last Update Date | 30/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200210020 | (05) | IN |
F77482 | (02) | IN |