Healthcare Provider Details

I. General information

NPI: 1265647150
Provider Name (Legal Business Name): NABEEL KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5308 HARROUN RD STE 180
SYLVANIA OH
43560-2190
US

IV. Provider business mailing address

5308 HARROUN RD STE 180
SYLVANIA OH
43560-2190
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-5207
  • Fax: 419-824-5208
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number249477
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number4301079544
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number4301079544
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number35.129955
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301079544
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35.129955
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: