Provider Demographics
NPI:1033253992
Name:F KHAN MD PC
Entity Type:Organization
Organization Name:F KHAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-235-1331
Mailing Address - Street 1:3433 FENTON RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1577
Mailing Address - Country:US
Mailing Address - Phone:810-235-1331
Mailing Address - Fax:810-235-8656
Practice Address - Street 1:3433 FENTON RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1577
Practice Address - Country:US
Practice Address - Phone:810-233-5133
Practice Address - Fax:810-235-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4301061370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N41530Medicare PIN