Provider Demographics
NPI:1043205297
Name:KHAN, ABRAR U (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAR
Middle Name:U
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 1:5555 W THUNDERBIRD
Mailing Address - Street 2:BANNER THUNDERBIRD MEDICAL CENTER
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306
Mailing Address - Country:US
Mailing Address - Phone:602-865-2627
Mailing Address - Fax:602-865-2632
Practice Address - Street 1:5555 W THUNDERBIRD
Practice Address - Street 2:BANNER THUNDERBIRD MEDICAL CENTER
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306
Practice Address - Country:US
Practice Address - Phone:602-865-2627
Practice Address - Fax:602-865-2631
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40516207R00000X, 207RC0200X, 207P00000X
IN01052867207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200373430Medicaid
IN232850Medicare PIN
IN200373430Medicaid
INH42266Medicare UPIN