Healthcare Provider Details

I. General information

NPI: 1942989710
Provider Name (Legal Business Name): EIRAJ KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 E BANNER GATEWAY DR STE 450
GILBERT AZ
85234-2178
US

IV. Provider business mailing address

4510 E BANNER GATEWAY DR APT 3060
MESA AZ
85206-4759
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-3340
  • Fax:
Mailing address:
  • Phone: 412-430-1061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT228896
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: