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General NPI Number Information
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NPI Number | 1952576399
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Entity Type | Organization
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Legal Business Name | M.O. KHAN, MD.,PA.
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 55 IRVING ST
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City | BARNWELL
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State | SC
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Zip | 29812-1535
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Country | US
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Telephone | 803-259-5150
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Fax | 803-259-9078
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Provider Business Mailing Address
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Address Line | 55 IRVING ST
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City | BARNWELL
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State | SC
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Zip | 29812-1535
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Country | US
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Telephone | 803-259-5150
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Fax | 803-259-9078
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Authorized Official
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Title or Position | OWNER
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Name | M. O. KHAN
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Credential | M.D.
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Telephone | 803-259-5150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 8422
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License Number State | SC
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