Provider Demographics
NPI:1982865671
Name:KHAN, KHURAM A (DO)
Entity type:Individual
Prefix:DR
First Name:KHURAM
Middle Name:A
Last Name:KHAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7957 N UNIVERSITY DR # 110
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2601
Mailing Address - Country:US
Mailing Address - Phone:305-450-4103
Mailing Address - Fax:
Practice Address - Street 1:732 S 6TH ST STE N
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6948
Practice Address - Country:US
Practice Address - Phone:305-450-4103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248933-1207L00000X
FLOS11723207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology