Provider Demographics
NPI:1164410833
Name:KHAN, ELIZABETH ACTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ACTON
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1146 S CEDAR CREST BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7938
Mailing Address - Country:US
Mailing Address - Phone:610-366-9000
Mailing Address - Fax:610-366-9229
Practice Address - Street 1:1146 S CEDAR CREST BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7938
Practice Address - Country:US
Practice Address - Phone:610-366-9000
Practice Address - Fax:610-366-9229
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD050725L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015450960002Medicaid
PA0015450960002Medicaid
PA010332Medicare ID - Type Unspecified