Healthcare Provider Details

I. General information

NPI: 1184959355
Provider Name (Legal Business Name): UZMA AHMAD KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N SAGINAW ST
FLINT MI
48505-4452
US

IV. Provider business mailing address

225 E 5TH ST SUITE 300
FLINT MI
48502-1641
US

V. Phone/Fax

Practice location:
  • Phone: 810-789-9141
  • Fax:
Mailing address:
  • Phone: 810-406-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301094692
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: