MEDICARE: DR. AHMAD NAWAZ 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	2084P0800X	Psychiatry Physician	D0056066	MD

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	:	1538120613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMAD NAWAZ KHAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 77
Second Line	:
City	:	GLENELG
State	:	MD
Zip	:	21737-0077
Country	:	US
Telephone Number	:	410-310-7594
Fax Number	:	443-542-0870

Provider Business Practice Location Address
First Line	:	3355 ST JOHN'S LANE
Second Line	:	SUITE F
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-7148
Country	:	US
Telephone Number	:	410-310-7594
Fax Number	:	443-542-0870

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	11/04/2024

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