Healthcare Provider Details

I. General information

NPI: 1750673729
Provider Name (Legal Business Name): AL-FALAH GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3118 MILTON RD A
CHARLOTTE NC
28215
US

IV. Provider business mailing address

3118 MILTON RD A
CHARLOTTE NC
28215
US

V. Phone/Fax

Practice location:
  • Phone: 704-536-0073
  • Fax: 704-535-1191
Mailing address:
  • Phone: 704-536-0073
  • Fax: 704-535-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number9900566
License Number StateNC

VIII. Authorized Official

Name: DR. KAMAL KHAN
Title or Position: OWNER
Credential: M.D.
Phone: 704-536-0073