Provider Demographics
NPI:1235112228
Name:KHAN, NOOR A (MD)
Entity Type:Individual
Prefix:
First Name:NOOR
Middle Name:A
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 LOCUST STREET
Mailing Address - Street 2:UPMC MERCY HEALTH CENTER ADULT INTERNAL MEDICINE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219
Mailing Address - Country:US
Mailing Address - Phone:412-232-7685
Mailing Address - Fax:412-232-7158
Practice Address - Street 1:1515 LOCUST ST
Practice Address - Street 2:MERCY HEALTH CENTER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5131
Practice Address - Country:US
Practice Address - Phone:412-232-7685
Practice Address - Fax:412-232-7158
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417004173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001858009Medicaid
PAH50132Medicare UPIN
PA001858009Medicaid