MEDICARE: US ARMY MEDDAC

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	286500000X	Military Hospital		GA

General Provider Information

NPI Number	:	1144301862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	US ARMY MEDDAC

Provider Business Mailing Address
First Line	:	7950 MARTIN LOOP
Second Line	:	MARTIN ARMY COMM HOSPTAL FT.BENNING
City	:	COLUMBUS
State	:	GA
Zip	:	31905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7950 MARTIN LOOP
Second Line	:	MARTIN ARMY COMM HOSPTAL FT.BENNING
City	:	COLUMBUS
State	:	GA
Zip	:	31905
Country	:	US
Telephone Number	:	706-544-1946
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ZEHERA N.A KHAN
Credential	:	MD
Telephone Number	:	706-544-1946

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/22/2020

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