Provider Demographics
NPI:1447234513
Name:KHAN, YASMIN (MD)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:
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 1:3130 FAIRVIEW PARK DR.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042
Mailing Address - Country:US
Mailing Address - Phone:703-914-2942
Mailing Address - Fax:703-207-7065
Practice Address - Street 1:1107 S WALTER REED DR APT 204
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4371
Practice Address - Country:US
Practice Address - Phone:302-786-7862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2042207R00000X
VA0101253110207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100070504Medicaid
TX100070505Medicaid
TX100070503Medicaid
TX8U7224OtherBLUE CROSS BLUE SHIELD
TX8U7224OtherBLUE CROSS BLUE SHIELD
8G2521Medicare PIN