MEDICARE: MR. DOST MOHAMMAD KHATTAK MD

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	207R00000X	Internal Medicine Physician	9080	AL

General Provider Information

NPI Number	:	1427005560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DOST MOHAMMAD KHATTAK MD

Provider Business Mailing Address
First Line	:	333 WHITESPORT DR
Second Line	:	STE 304
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-3455
Country	:	US
Telephone Number	:	256-880-0800
Fax Number	:	256-882-3556

Provider Business Practice Location Address
First Line	:	333 WHITESPORT DR
Second Line	:	STE 304
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-3455
Country	:	US
Telephone Number	:	256-880-0800
Fax Number	:	256-882-3556

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	07/08/2007

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