Healthcare Provider Details

I. General information

NPI: 1184276743
Provider Name (Legal Business Name): SAAD KHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2019
Last Update Date: 09/05/2022
Certification Date: 09/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

IV. Provider business mailing address

22201 MOROSS RD STE 80
DETROIT MI
48236-2169
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-49570
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: