Provider Demographics
NPI:1093707218
Name:KHAN, SAAD Z (MD)
Entity Type:Individual
Prefix:
First Name:SAAD
Middle Name:Z
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:777 CRAIG RD STE 130
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7133
Mailing Address - Country:US
Mailing Address - Phone:314-872-7792
Mailing Address - Fax:314-872-5655
Practice Address - Street 1:777 CRAIG RD STE 130
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-7133
Practice Address - Country:US
Practice Address - Phone:314-872-7792
Practice Address - Fax:314-872-5655
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO1002592084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207083205Medicaid
MO5672OtherANTHEM BCBS
MO5672OtherANTHEM BCBS
MO081077OtherVALUE OPTIONS
MO136845OtherHEALTHLINK
MO5672OtherANTHEM BCBS