Provider Demographics
NPI:1154304210
Name:KHAN-ARTHUR, GREGORY AHAMAD (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:AHAMAD
Last Name:KHAN-ARTHUR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-5614
Mailing Address - Country:US
Mailing Address - Phone:347-406-1572
Mailing Address - Fax:
Practice Address - Street 1:375 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5614
Practice Address - Country:US
Practice Address - Phone:347-406-1572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0007785207Q00000X
NY258411207Q00000X
PAOS015537207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102590624Medicaid
PA417117OtherUPMC
PA2595811OtherHIGHMARK BLUE SHIELD
PAP010906OtherGATEWAY
PA102590624Medicaid