Healthcare Provider Details

I. General information

NPI: 1538229612
Provider Name (Legal Business Name): IRFAN MAQBOOL KHURRAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W STATE ST
DOYLESTOWN PA
18901-3525
US

IV. Provider business mailing address

PO BOX 829641
PHILADELPHIA PA
19182-0001
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-1900
  • Fax: 215-345-4579
Mailing address:
  • Phone: 267-370-5295
  • Fax: 215-230-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD450897
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD450897
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: