Healthcare Provider Details

I. General information

NPI: 1538503081
Provider Name (Legal Business Name): MONICA KHAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 JESSE HILL JR DR SE
ATLANTA GA
30303-3049
US

IV. Provider business mailing address

531 ASBURY CIR HOSPITAL ANNEX-SUITE N340
ATLANTA GA
30322-3049
US

V. Phone/Fax

Practice location:
  • Phone: 404-251-8850
  • Fax: 404-688-6355
Mailing address:
  • Phone: 404-778-2624
  • Fax: 404-688-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number076344
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35C.001131
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: