Provider Demographics
NPI:1316992571
Name:KHAN, ASMA S (OD)
Entity type:Individual
Prefix:DR
First Name:ASMA
Middle Name:S
Last Name:KHAN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:STE 520
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3990
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:703-991-0514
Practice Address - Street 1:3214 CHARLES B ROOT WYND
Practice Address - Street 2:STE 120
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-5440
Practice Address - Country:US
Practice Address - Phone:919-881-0900
Practice Address - Fax:919-881-0911
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC1864152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093U3OtherBCBS
NC5904878Medicaid
NC5904878Medicaid
NC5904878Medicaid