Healthcare Provider Details

I. General information

NPI: 1497938922
Provider Name (Legal Business Name): KHAN MEDICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2007
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PENN AVE
PITTSBURGH PA
15221-2156
US

IV. Provider business mailing address

200 PENN AVE
PITTSBURGH PA
15221-2156
US

V. Phone/Fax

Practice location:
  • Phone: 412-242-8860
  • Fax: 412-242-8863
Mailing address:
  • Phone: 412-242-8860
  • Fax: 412-242-8863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ABDUL Q KHAN
Title or Position: OWNER
Credential: MD, MPM
Phone: 412-242-8860