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NPI Code Detail

MEDICARE: SHAWAN MEHDI KHAN PHARM. D.

MEDICARE: SHAWAN MEHDI KHAN PHARM. 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
1183500000XPharmacist5302045241MI

General Provider Information

NPI Number : 1982258836
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWAN MEHDI KHAN PHARM. D.
Provider Business Mailing Address
First Line : 2772 TITTABAWASSEE RD
Second Line :
City : SAGINAW
State : MI
Zip : 48604-9433
Country : US
Telephone Number : 989-793-5701
Fax Number : 989-484-9263
Provider Business Practice Location Address
First Line : 800 LEONARD ST NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-4148
Country : US
Telephone Number : 616-458-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2019
Last Update Date : 02/23/2020

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