MEDICARE: DR. MADHU PRIYA P KHANNA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	MD036654	DC
2	208800000X	Urology Physician	0101242442	VA
3	208800000X	Urology Physician	D66105	MD

General Provider Information

NPI Number	:	1154309813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADHU PRIYA P KHANNA MD

Provider Business Mailing Address
First Line	:	2101 E JEFFERSON ST
Second Line	:	KAISER PERMANENTE MEDICARE ENROLLMENT
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-4908
Country	:	US
Telephone Number	:	301-816-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 MERCANTILE LN
Second Line	:
City	:	LARGO
State	:	MD
Zip	:	20774-5374
Country	:	US
Telephone Number	:	301-618-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	06/25/2021

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