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General NPI Number Information
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NPI Number | 1669449435
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Entity Type | Individual
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Provider Name | KANWAL S KHAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 14631 LEE HWY SUITE 405
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City | CENTREVILLE
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State | VA
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Zip | 20121-5824
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Country | US
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Telephone | 703-830-1950
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Fax | 703-830-2070
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Provider Business Mailing Address
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Address Line | 3517 W OX RD
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City | FAIRFAX
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State | VA
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Zip | 22033-1705
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Country | US
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Telephone | 814-938-3343
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Fax | 814-938-3369
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101235933
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License Number State | VA
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