Provider Demographics
NPI:1073593885
Name:KHAN, YUSUF HAMEED (MD)
Entity type:Individual
Prefix:DR
First Name:YUSUF
Middle Name:HAMEED
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43150 BROADLANDS CENTER PLAZA
Mailing Address - Street 2:SUITE #184
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148
Mailing Address - Country:US
Mailing Address - Phone:703-723-7110
Mailing Address - Fax:703-723-7114
Practice Address - Street 1:11484 WASHINGTON PAZA W
Practice Address - Street 2:SUITE #300
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-443-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV22062207PE0004X, 207Q00000X
VA0101249245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004432Medicaid
WV2031343Medicare PIN
WV2031345Medicare PIN
WVI49205Medicare UPIN
WV3810004432Medicaid
WV2031344Medicare PIN
WVWV0704B987Medicare PIN
WVWV0704BMedicare PIN
WV2031342Medicare PIN
WVWV0704AMedicare PIN
WV2031341Medicare PIN