Provider Demographics
NPI:1164782637
Name:SAXON INTERNAL MEDICINE P A
Entity Type:Organization
Organization Name:SAXON INTERNAL MEDICINE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UZMA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED KHURSHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-694-5984
Mailing Address - Street 1:2574 S VOLUSIA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-9123
Mailing Address - Country:US
Mailing Address - Phone:386-775-1086
Mailing Address - Fax:386-775-8990
Practice Address - Street 1:2574 S VOLUSIA AVE
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-9123
Practice Address - Country:US
Practice Address - Phone:386-775-1086
Practice Address - Fax:386-775-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGK791AMedicare PIN