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NPI Code Detail

MEDICARE: MOHAMMED-ABDUL KHAN, DDS, MD, LLC

MEDICARE: MOHAMMED-ABDUL KHAN, DDS, MD, LLC
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
11223S0112XOral and Maxillofacial Surgery (Dentist)DS029596LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942554704
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOHAMMED-ABDUL KHAN, DDS, MD, LLC
Provider Business Mailing Address
First Line : 3515 WASHINGTON RD
Second Line : SUITE # 562
City : MC MURRAY
State : PA
Zip : 15317-3063
Country : US
Telephone Number : 724-260-5184
Fax Number :
Provider Business Practice Location Address
First Line : 3515 WASHINGTON RD
Second Line : SUITE # 562
City : MC MURRAY
State : PA
Zip : 15317-3063
Country : US
Telephone Number : 724-260-5184
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MOHAMMED-ABDUL KHAN
Credential : DDS, MD
Telephone Number : 724-260-5184
Provider Enumeration Date : 11/01/2012
Last Update Date : 11/01/2012

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