Provider Demographics
NPI:1841074911
Name:KHAN, NOMAN (MD)
Entity type:Individual
Prefix:
First Name:NOMAN
Middle Name:
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 1:1105 W NC HIGHWAY 54 BYP
Mailing Address - Street 2:W4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516
Mailing Address - Country:US
Mailing Address - Phone:563-265-3290
Mailing Address - Fax:
Practice Address - Street 1:2034 OLD CLINIC BLDG., CB# 7510
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7510
Practice Address - Country:US
Practice Address - Phone:984-215-8512
Practice Address - Fax:919-962-9625
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRTL23-1052390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program