MEDICARE: ABEDA ALI 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
1	207R00000X	Internal Medicine Physician	D43323	MD

General Provider Information

NPI Number	:	1407894140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABEDA ALI KHAN M.D.

Provider Business Mailing Address
First Line	:	8118 BROOKWOOD FARM RD
Second Line	:
City	:	FULTON
State	:	MD
Zip	:	20759-9658
Country	:	US
Telephone Number	:	301-725-1393
Fax Number	:

Provider Business Practice Location Address
First Line	:	10820 HICKORY RIDGE RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3622
Country	:	US
Telephone Number	:	410-730-9526
Fax Number	:	410-730-7509

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	07/08/2007

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