Healthcare Provider Details

I. General information

NPI: 1760572150
Provider Name (Legal Business Name): SAADAT ALI KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 03/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2991 CROUSE LN
BURLINGTON NC
27215-8833
US

IV. Provider business mailing address

2991 CROUSE LN
BURLINGTON NC
27215-8833
US

V. Phone/Fax

Practice location:
  • Phone: 336-586-0994
  • Fax: 336-586-9363
Mailing address:
  • Phone: 336-586-0994
  • Fax: 336-586-9363

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number9701005
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9701005
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number97-01005
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number97-01005
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: