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NPI Code Detail

MEDICARE: MADIHA AFREEN KHAN M.D.

MEDICARE: MADIHA AFREEN KHAN M.D.
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
1207Q00000XFamily Medicine Physician18226NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255728911
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADIHA AFREEN KHAN M.D.
Provider Business Mailing Address
First Line : 3170 KETTERING BLVD BLDG B2ND
Second Line :
City : MORAINE
State : OH
Zip : 45439-1924
Country : US
Telephone Number : 937-991-3188
Fax Number :
Provider Business Practice Location Address
First Line : 2451 WAYNE AVE
Second Line :
City : DAYTON
State : OH
Zip : 45420-1893
Country : US
Telephone Number : 937-208-7377
Fax Number : 937-208-7375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2015
Last Update Date : 05/13/2025

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