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NPI Code Detail

MEDICARE: MALIHA W KHAN M.D.

MEDICARE:   MALIHA W 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 PhysicianME91352FL

General Provider Information

NPI Number : 1679636500
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALIHA W KHAN M.D.
Provider Business Mailing Address
First Line : 5150 NW MILNER DR
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34983-3392
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 714 AVENUE C
Second Line :
City : FORT PIERCE
State : FL
Zip : 34950-4189
Country : US
Telephone Number : 772-462-3800
Fax Number : 772-462-3865
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 07/09/2007

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Directions to “ MALIHA W KHAN M.D.” Practice Location

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