Healthcare Provider Details

I. General information

NPI: 1316067820
Provider Name (Legal Business Name): INAM KHAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MCCONNELL DR
COLUMBUS OH
43214-3463
US

IV. Provider business mailing address

800 MCCONNELL DR
COLUMBUS OH
43214-3463
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-6297
  • Fax:
Mailing address:
  • Phone: 614-533-6297
  • Fax: 614-533-6226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.010135CTR
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: