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1710278270

NPI Code Detail

MEDICARE: SAMAD SIRAZ KHAN MD

MEDICARE: SAMAD SIRAZ 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	208M00000X	Hospitalist Physician	258834	MA
2	207R00000X	Internal Medicine Physician	258834	MA
3	207R00000X	Internal Medicine Physician	276497	NY
4	207R00000X	Internal Medicine Physician	MD2017-0804	NM
5	208M00000X	Hospitalist Physician	276497	NY

General Provider Information

NPI Number	:	1710278270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMAD SIRAZ KHAN MD

Provider Business Mailing Address
First Line	:	55 FOGG RD
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-2432
Country	:	US
Telephone Number	:	781-624-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 FOGG RD
Second Line	:
City	:	SOUTH WEYMOUTH
State	:	MA
Zip	:	02190-2455
Country	:	US
Telephone Number	:	781-624-8000
Fax Number	:

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

Provider Enumeration Date	:	05/02/2011
Last Update Date	:	12/22/2025

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Directions to “ SAMAD SIRAZ KHAN MD” Practice Location

Language	Start Address	Practice Location

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