Provider Demographics
NPI:1205217981
Name:KHAN, JAHANGIR
Entity Type:Individual
Prefix:
First Name:JAHANGIR
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-2256
Mailing Address - Country:US
Mailing Address - Phone:484-526-7800
Mailing Address - Fax:866-732-7151
Practice Address - Street 1:1469 8TH AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-2256
Practice Address - Country:US
Practice Address - Phone:484-526-7800
Practice Address - Fax:866-732-7151
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT209760207R00000X
PAMD465682207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine