Healthcare Provider Details
I. General information
NPI: 1497286207
Provider Name (Legal Business Name): IRFAN JAMIL KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/23/2017
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 OSTRUM ST
BETHLEHEM PA
18015-1000
US
IV. Provider business mailing address
801 OSTRUM ST
BETHLEHEM PA
18015-1000
US
V. Phone/Fax
- Phone: 866-785-8537
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | MD477493 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: