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General NPI Number Information
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NPI Number | 1306508213
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Entity Type | Organization
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Legal Business Name | MD COVID CARE PLLC
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Dates
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Enumeration Date | 10/07/2021
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 15414 ASH WAY
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City | LYNNWOOD
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State | WA
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Zip | 98087-8737
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Country | US
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Telephone | 425-403-2010
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Fax | 972-483-4179
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Provider Business Mailing Address
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Address Line | 906 FALCON TRL
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City | MURPHY
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State | TX
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Zip | 75094-3836
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Country | US
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Telephone | 425-403-2010
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Fax | 972-483-4179
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | ZEESHAN KHAN
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Credential | MD
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Telephone | 425-403-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080B0002X
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Taxonomy Name | Pediatric Obesity Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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