MEDICARE: TANWEER H. KHAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	36688	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093798365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANWEER H. KHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 973357
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75397-3357
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6005 DELMONICO DR
Second Line	:	SUITE 180
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80919-2237
Country	:	US
Telephone Number	:	719-542-7891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	11/18/2009

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