Provider Demographics
NPI:1083663819
Name:KHAN, SAAD M (MD)
Entity Type:Individual
Prefix:DR
First Name:SAAD
Middle Name:M
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 1:2541 S VOLUSIA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-9116
Mailing Address - Country:US
Mailing Address - Phone:386-218-6893
Mailing Address - Fax:386-218-6895
Practice Address - Street 1:2541 S VOLUSIA AVE STE 300
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-9116
Practice Address - Country:US
Practice Address - Phone:386-218-6893
Practice Address - Fax:386-218-6895
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90434207RG0100X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270860400Medicaid
FL270860400Medicaid