Healthcare Provider Details

I. General information

NPI: 1568339646
Provider Name (Legal Business Name): ATIYA B KHAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14333 LAUREL BOWIE RD STE 303
LAUREL MD
20708-1183
US

IV. Provider business mailing address

14333 LAUREL BOWIE RD STE 303
LAUREL MD
20708-1183
US

V. Phone/Fax

Practice location:
  • Phone: 301-725-4334
  • Fax: 301-725-8073
Mailing address:
  • Phone: 301-725-4334
  • Fax: 301-725-8073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
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: DR. ATIYA BATOOL KHAN
Title or Position: OWNER
Credential: MD
Phone: 301-725-4334