Healthcare Provider Details

I. General information

NPI: 1386132231
Provider Name (Legal Business Name): USMAN TARIQ KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2018
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 HARRY S TRUMAN DR N STE 550
UPPER MARLBORO MD
20774-5485
US

IV. Provider business mailing address

6330 LITTLE OX RD
FAIRFAX STATION VA
22039-1666
US

V. Phone/Fax

Practice location:
  • Phone: 301-627-3500
  • Fax:
Mailing address:
  • Phone: 347-217-8076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0106197
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: