Provider Demographics
NPI:1497869713
Name:KHAN, MOHAMMAD A (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:98 FORD RD
Mailing Address - Street 2:SUITE 3-H
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1374
Mailing Address - Country:US
Mailing Address - Phone:973-625-3366
Mailing Address - Fax:973-625-0349
Practice Address - Street 1:651 WILLOW GROVE ST
Practice Address - Street 2:PATHOLOGY DEPARTMENT
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1799
Practice Address - Country:US
Practice Address - Phone:908-850-6948
Practice Address - Fax:908-441-1408
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-03-30
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Provider Licenses
StateLicense IDTaxonomies
NJ25 MA07498200207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5428203Medicaid
NJ5428203Medicaid
NJC90798Medicare UPIN