MEDICARE: DR. TINA ASHLEY KHAIR D.O.

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	390200000X	Student in an Organized Health Care Education/Training Program		NY
2	207RH0003X	Hematology & Oncology Physician	OS015965	PA
3	207RH0003X	Hematology & Oncology Physician	H0074458	MD

General Provider Information

NPI Number	:	1730338112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA ASHLEY KHAIR D.O.

Provider Business Mailing Address
First Line	:	9050 IRON HORSE LN
Second Line	:	APT 404
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-2154
Country	:	US
Telephone Number	:	703-371-6346
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 EXPEDITION TRL
Second Line	:	SUITE 101
City	:	GETTYSBURG
State	:	PA
Zip	:	17325-8598
Country	:	US
Telephone Number	:	717-334-4033
Fax Number	:	717-334-5599

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

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	02/25/2016

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