MEDICARE: MS. NASIM S. 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	207VX0000X	Obstetrics Physician	ME94450	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30987	OTHER	FL	BCBS
2	P00663361	OTHER	FL	RRMC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568458883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NASIM S. KHAN M.D.

Provider Business Mailing Address
First Line	:	919 MALL RING RD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8515
Country	:	US
Telephone Number	:	863-471-1703
Fax Number	:	863-471-6229

Provider Business Practice Location Address
First Line	:	919 MALL RING RD
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33870-8515
Country	:	US
Telephone Number	:	863-471-1703
Fax Number	:	863-471-6229

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	01/03/2013

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