Provider Demographics
NPI:1043267016
Name:KHAN, MOHAMMAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4915 AUBURN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2636
Mailing Address - Country:US
Mailing Address - Phone:301-907-3939
Mailing Address - Fax:301-656-3943
Practice Address - Street 1:730 24TH ST NW
Practice Address - Street 2:SUITE 17
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2543
Practice Address - Country:US
Practice Address - Phone:202-337-7660
Practice Address - Fax:202-625-6018
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD30300207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC023731600Medicaid
DCG58583Medicare UPIN
DC023731600Medicaid