Provider Demographics
NPI:1487855227
Name:A.K.MEDICAL ASSOCIATES.P.C
Entity Type:Organization
Organization Name:A.K.MEDICAL ASSOCIATES.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-520-9311
Mailing Address - Street 1:504 CRAIG LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1902
Mailing Address - Country:US
Mailing Address - Phone:610-520-9311
Mailing Address - Fax:
Practice Address - Street 1:5402 W.GIRARD AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131
Practice Address - Country:US
Practice Address - Phone:215-477-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039585L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001006368Medicaid
PA001958167Medicaid
PA007796244Medicaid
PAH74011Medicare UPIN
PA007796244Medicaid
PAKH127841Medicare ID - Type Unspecified
PA001006368Medicaid
PAH51431Medicare UPIN
PA127841Medicare ID - Type Unspecified
PA071380Medicare ID - Type Unspecified
PAJA071380Medicare ID - Type Unspecified