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General NPI Number Information
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NPI Number | 1114100583
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Entity Type | Individual
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Provider Name | SHALLA H KHAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2007
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 604 SOLAREX COURT SUITE 206
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City | FREDERICK
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State | MD
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Zip | 21703
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Country | US
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Telephone | 301-663-0006
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Fax | 301-663-0688
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Provider Business Mailing Address
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Address Line | 19328 ERIN TREE CT
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City | GAITHERSBURG
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State | MD
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Zip | 20879
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Country | US
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Telephone | 240-271-0745
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Fax | 301-527-9423
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | D42194
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | D42194
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License Number State | MD
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