Provider Demographics
NPI:1386633543
Name:KHAN, ZIA UDDIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIA
Middle Name:UDDIN
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:PO BOX 371543
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-1543
Mailing Address - Country:US
Mailing Address - Phone:702-822-2273
Mailing Address - Fax:702-734-3278
Practice Address - Street 1:5785 S FORT APACHE RD
Practice Address - Street 2:SUITE A-100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5659
Practice Address - Country:US
Practice Address - Phone:702-822-2273
Practice Address - Fax:702-734-3278
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8956174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2018151Medicaid
NVF91381Medicare UPIN
NV2018151Medicaid