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General NPI Number Information
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NPI Number | 1013336031
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Entity Type | Individual
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Provider Name | SAMIRA KHAN MD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 930 CHESTNUT RIDGE RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-2807
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Country | US
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Telephone | 304-293-5312
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Fax | 304-581-1936
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Provider Business Mailing Address
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Address Line | 1 MEDICAL CENTER DRIVE DEPARTMENT OF BEHAVIORAL HEALTH AND MEDICINE
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City | MORGANTOWN
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State | WV
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Zip | 26505
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Country | US
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Telephone | 518-262-3095
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 27695
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License Number State | WV
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