Provider Demographics
NPI:1184683435
Name:KHAN, SHARIF S (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARIF
Middle Name:S
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:104 INNOVATION DRIVE
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-603-6300
Mailing Address - Fax:864-603-6140
Practice Address - Street 1:104 INNOVATION DRIVE
Practice Address - Street 2:SUITE 2000
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-603-6300
Practice Address - Fax:864-603-6140
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD426227207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101253998Medicaid
PA090680Medicare ID - Type Unspecified