MEDICARE: DR. ASMA S. KHAN OD

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	152W00000X	Optometrist	OPC5579	FL
2	152W00000X	Optometrist	046.011448	IL
3	152W00000X	Optometrist	4901005712	MI

General Provider Information

NPI Number	:	1811475478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASMA S. KHAN OD

Provider Business Mailing Address
First Line	:	4718 MADDIE LN
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48126-4174
Country	:	US
Telephone Number	:	773-414-0707
Fax Number	:

Provider Business Practice Location Address
First Line	:	26671 FORD RD
Second Line	:
City	:	DEARBORN HEIGHTS
State	:	MI
Zip	:	48127-2856
Country	:	US
Telephone Number	:	734-458-5181
Fax Number	:	734-458-8080

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

Provider Enumeration Date	:	08/04/2018
Last Update Date	:	08/11/2024

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