Provider Demographics
NPI:1396430377
Name:KHAN, OWAIS MAQSOOD
Entity type:Individual
Prefix:
First Name:OWAIS
Middle Name:MAQSOOD
Last Name:KHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 AKRON ST
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-1100
Mailing Address - Country:US
Mailing Address - Phone:571-477-9435
Mailing Address - Fax:
Practice Address - Street 1:2995 AKRON ST
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-1100
Practice Address - Country:US
Practice Address - Phone:571-477-9435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)