Provider Demographics
NPI:1033256631
Name:KHAN, LUBNA N (MD)
Entity Type:Individual
Prefix:DR
First Name:LUBNA
Middle Name:N
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUBNA
Other - Middle Name:
Other - Last Name:NASIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12339 WAKE FOREST RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1521
Mailing Address - Country:US
Mailing Address - Phone:410-531-5466
Mailing Address - Fax:410-531-6132
Practice Address - Street 1:5005 SIGNAL BELL LANE
Practice Address - Street 2:SUITE 102
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029
Practice Address - Country:US
Practice Address - Phone:410-531-5466
Practice Address - Fax:410-531-6132
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056394207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD450RMedicare ID - Type Unspecified
MDH29086Medicare UPIN