Provider Demographics
NPI:1487823654
Name:KHAN, MOHAMMAD KHURRAM (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:KHURRAM
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:1365 CLIFTON RD NE
Mailing Address - Street 2:RADIATION ONCOLOGY DEPARTMENT-EMORY UNIVERSITY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-3473
Mailing Address - Fax:404-778-3643
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:RADIATION ONCOLOGY DEPARTMENT-EMORY UNIVERSITY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-3473
Practice Address - Fax:404-778-3643
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHTRAINING LICENSE2085R0203X
GA65834261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology