Provider Demographics
NPI:1295019727
Name:KHAN, ZIA R (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIA
Middle Name:R
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 GLEN EDEN CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8436
Mailing Address - Country:US
Mailing Address - Phone:330-562-9650
Mailing Address - Fax:
Practice Address - Street 1:640 GLEN EDEN CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8436
Practice Address - Country:US
Practice Address - Phone:330-562-9650
Practice Address - Fax:330-995-2650
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.043370207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy