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General NPI Number Information
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NPI Number | 1306953559
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Entity Type | Organization
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Legal Business Name | MASOOD H KHAN MD PA
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 6725 CEDAR RIDGE DR STE 1
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-7515
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Country | US
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Telephone | 813-780-9616
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Fax | 813-788-6866
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Provider Business Mailing Address
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Address Line | 6725 CEDAR RIDGE DR STE 1
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542-7515
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Country | US
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Telephone | 813-780-9616
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Fax | 813-788-6866
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Authorized Official
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Title or Position | M.D.
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Name | DR. MASOOD H KHAN
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Credential | M.D.
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Telephone | 813-780-9616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME88950
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License Number State | FL
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