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General NPI Number Information
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NPI Number | 1386132231
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Entity Type | Individual
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Provider Name | USMAN TARIQ KHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 6045 BURKE CENTRE PKWY
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City | BURKE
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State | VA
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Zip | 22015-3751
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Country | US
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Telephone | 703-596-4848
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Fax |
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Provider Business Mailing Address
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Address Line | 6330 LITTLE OX RD
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City | FAIRFAX STATION
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State | VA
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Zip | 22039-1666
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Country | US
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Telephone | 347-217-8076
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101273957
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License Number State | VA
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