Healthcare Provider Details

I. General information

NPI: 1679739627
Provider Name (Legal Business Name): JAHANGIR KHAN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 03/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9114 PHILADELPHIA RD SUITE 304
BALTIMORE MD
21237-4345
US

IV. Provider business mailing address

10845 PHILADELPHIA RD
WHITE MARSH MD
21162-1717
US

V. Phone/Fax

Practice location:
  • Phone: 410-687-7010
  • Fax: 410-687-8095
Mailing address:
  • Phone: 410-335-0008
  • Fax: 410-335-1133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0022503
License Number StateMD

VIII. Authorized Official

Name: JAHANGIR M. KHAN
Title or Position: OWNER
Credential: M.D.
Phone: 410-335-0008