Provider Demographics
NPI:1699950220
Name:KHAN, SOFIA NAZ-ORAKZAI (MD)
Entity type:Individual
Prefix:DR
First Name:SOFIA
Middle Name:NAZ-ORAKZAI
Last Name:KHAN
Suffix:
Gender:F
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:PO BOX 921476
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30010-1476
Mailing Address - Country:US
Mailing Address - Phone:817-284-9850
Mailing Address - Fax:817-284-9859
Practice Address - Street 1:210 COLLINS INDUSTRIAL WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5450
Practice Address - Country:US
Practice Address - Phone:678-442-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA65324207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA065324OtherGEORGIA MEDICAL LICENSE
AZ81732OtherTRAINING PERMIT
AZ40422OtherARIZONA MEDICAL LICENSE