Healthcare Provider Details

I. General information

NPI: 1427481472
Provider Name (Legal Business Name): MUHAMMAD ALI KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SW 78TH AVE APT 501
PLANTATION FL
33324-3373
US

IV. Provider business mailing address

700 SW 78TH AVE APT 501
PLANTATION FL
33324-3373
US

V. Phone/Fax

Practice location:
  • Phone: 832-359-5178
  • Fax: 414-805-6851
Mailing address:
  • Phone: 832-359-5178
  • Fax: 414-805-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number4301511430
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number65642
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number4301511430
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME156502
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME156502
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: