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General NPI Number Information
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NPI Number | 1538266994
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Entity Type | Organization
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Legal Business Name | KHAN PEDIATRIC CARE P.C.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 44121 HARRY BYRD HWY. SUITE 215
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City | ASHBURN
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State | VA
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Zip | 20147
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Country | US
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Telephone | 703-727-6664
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Fax |
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Provider Business Mailing Address
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Address Line | 1251 ROWLAND DR
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City | HERNDON
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State | VA
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Zip | 20170-2430
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Country | US
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Telephone | 703-444-3876
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BASHIR A. KHAN
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Credential | M.D;F.A.A.P.
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Telephone | 703-727-6664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101049571
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License Number State | VA
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