Provider Demographics
NPI:1588753420
Name:KHAN, KHALID M (MD)
Entity type:Individual
Prefix:
First Name:KHALID
Middle Name:M
Last Name:KHAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1501 N CAMPBELL AVE
Mailing Address - Street 2:UNIVERSITY OF ARIZONA MEDICAL CENTER SUITE 4325F
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5066
Mailing Address - Country:US
Mailing Address - Phone:520-626-6211
Mailing Address - Fax:520-626-9226
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:UNIVERSITY OF ARIZONA MEDICAL CENTER SUITE 4325F
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5066
Practice Address - Country:US
Practice Address - Phone:520-626-6211
Practice Address - Fax:520-626-9226
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2012-04-23
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Provider Licenses
StateLicense IDTaxonomies
AZ404302080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1344716OtherARAZ
370002203Medicare ID - Type Unspecified
H32109Medicare UPIN