Healthcare Provider Details

I. General information

NPI: 1336844232
Provider Name (Legal Business Name): MAISHA ZAHIN KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 TANEY AVE STE AND202
FREDERICK MD
21702-4747
US

IV. Provider business mailing address

1219 DAHLIA LN
FREDERICK MD
21703-6197
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-0133
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0106458
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: