Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | MD426285 | PA |
NPI | 1104887686 |
---|---|
Provider Name | Taqi Ft Khan |
First Address | Philadelphia, PA 19120 |
Second Address | Philadelphia, PA 19141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H45539 | (02) |