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NPI Code Detail

MEDICARE: MUJEEB H KHAN MD

MEDICARE: MUJEEB H KHAN 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
12084P0800XPsychiatry Physician035941TN
22084P0800XPsychiatry PhysicianME98404FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00712608OTHERTNRR MEDICARE

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 : 1417924002
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUJEEB H KHAN MD
Provider Business Mailing Address
First Line : 9352 PARK WEST BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4325
Country : US
Telephone Number : 865-373-1745
Fax Number : 865-373-1747
Provider Business Practice Location Address
First Line : 9352 PARK WEST BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4325
Country : US
Telephone Number : 865-373-1745
Fax Number : 865-373-1747
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 07/10/2020

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