Provider Demographics
NPI:1497796619
Name:KHAN, REHAN (MD)
Entity Type:Individual
Prefix:
First Name:REHAN
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 N CHARLES ST
Mailing Address - Street 2:SUITE 4202
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6808
Mailing Address - Country:US
Mailing Address - Phone:410-838-4800
Mailing Address - Fax:443-817-9766
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:SUITE 4202
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:410-821-8444
Practice Address - Fax:410-821-8447
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD62300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406744400Medicaid
MDKR82K573Medicare PIN
MDI25043Medicare UPIN