Provider Demographics
NPI:1093704116
Name:KHIN, U (MD)
Entity Type:Individual
Prefix:
First Name:U
Middle Name:
Last Name:KHIN
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 1:37924 MEDICAL ARTS CT
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33541-4375
Mailing Address - Country:US
Mailing Address - Phone:813-779-1900
Mailing Address - Fax:813-779-8383
Practice Address - Street 1:37924 MEDICAL ARTS CT
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33541-4375
Practice Address - Country:US
Practice Address - Phone:813-779-1900
Practice Address - Fax:813-779-8383
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75158207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268137400Medicaid
FL71178OtherBCBS
FL71178WMedicare PIN
FL71178OtherBCBS
FL268137400Medicaid