Provider Demographics
NPI:1013003425
Name:KHAN, QAMAR J (MD)
Entity Type:Individual
Prefix:
First Name:QAMAR
Middle Name:J
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 210, MAIL STOP 5003
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-6029
Mailing Address - Fax:
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 210, MAIL STOP 5003
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28779207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO27824046OtherBCBS KC
MO205144801Medicaid
KS406120OtherFIRSTGUARD
KS100369040AMedicaid
MO27824046OtherBCBS KC
KS011A626AMedicare ID - Type Unspecified