Provider Demographics
NPI:1972898856
Name:KHAN, OMAR ALI (MD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:ALI
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4299
Mailing Address - Country:US
Mailing Address - Phone:192-144-2144
Mailing Address - Fax:419-479-5593
Practice Address - Street 1:3355 MEIJER DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-3102
Practice Address - Country:US
Practice Address - Phone:419-725-6850
Practice Address - Fax:419-724-9696
Is Sole Proprietor?:No
Enumeration Date:2011-06-18
Last Update Date:2024-06-25
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Provider Licenses
StateLicense IDTaxonomies
OH35.131247208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology