MEDICARE: AHSAN S 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
1	207YS0123X	Facial Plastic Surgery Physician	D72236	MD

General Provider Information

NPI Number	:	1467470567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AHSAN S KHAN MD

Provider Business Mailing Address
First Line	:	1710 WILLOW SPRINGS DR
Second Line	:
City	:	SYKESVILLE
State	:	MD
Zip	:	21784-5600
Country	:	US
Telephone Number	:	410-442-1842
Fax Number	:	410-442-1685

Provider Business Practice Location Address
First Line	:	1710 WILLOW SPRINGS DR
Second Line	:
City	:	SYKESVILLE
State	:	MD
Zip	:	21784-5600
Country	:	US
Telephone Number	:	410-442-1842
Fax Number	:	410-442-1685

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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