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NPI 1114849866

NPI 1114849866 : MOHAMMED SABAHATHULLAH KHAN MD : JEFFERSON, LA

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General NPI Number Information
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    NPI Number           |    1114849866
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    Entity Type          |    Individual 
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    Provider Name        |    MOHAMMED SABAHATHULLAH KHAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/27/2026
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    Last Update Date     |    07/27/2026
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Provider Practice Location Address
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    Address Line         |    1401A JEFFERSON HWY 
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    City                 |    JEFFERSON
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    State                |    LA
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    Zip                  |    70121-2426
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    Country              |    US
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    Telephone            |    504-842-3260
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    Fax                  |    504-842-3193
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Provider Business Mailing Address
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    Address Line         |    4409 TRENTON ST APT 416 
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    City                 |    METAIRIE
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    State                |    LA
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    Zip                  |    70006-6771
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    Country              |    US
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    Telephone            |    504-239-0130
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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