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General NPI Number Information
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NPI Number | 1346674801
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Entity Type | Individual
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Provider Name | FIZA KHAN MD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2013
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 401 N CARTER RD STE 201
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City | SMYRNA
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State | DE
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Zip | 19977-1281
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Country | US
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Telephone | 302-659-3257
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Fax | 302-653-3876
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Provider Business Mailing Address
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Address Line | 640 S. STATE STREET, MAIL CODE 3055
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City | DOVER
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State | DE
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Zip | 19901-3530
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Country | US
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Telephone | 302-659-3257
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Fax | 302-653-3876
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MT205232
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C1-0024854
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License Number State | DE
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