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General NPI Number Information
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NPI Number | 1144301862
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Entity Type | Organization
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Legal Business Name | US ARMY MEDDAC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7950 MARTIN LOOP MARTIN ARMY COMM HOSPTAL FT.BENNING
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City | COLUMBUS
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State | GA
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Zip | 31905
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Country | US
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Telephone | 706-544-1946
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Fax |
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Provider Business Mailing Address
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Address Line | 7950 MARTIN LOOP MARTIN ARMY COMM HOSPTAL FT.BENNING
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City | COLUMBUS
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State | GA
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Zip | 31905
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ZEHERA N.A KHAN
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Credential | MD
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Telephone | 706-544-1946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State | GA
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