Provider Demographics
NPI:1568458883
Name:KHAN, NASIM S (MD)
Entity Type:Individual
Prefix:MS
First Name:NASIM
Middle Name:S
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 1:919 MALL RING RD
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-8515
Mailing Address - Country:US
Mailing Address - Phone:863-471-1703
Mailing Address - Fax:863-471-6229
Practice Address - Street 1:919 MALL RING RD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-8515
Practice Address - Country:US
Practice Address - Phone:863-471-1703
Practice Address - Fax:863-471-6229
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94450207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30987OtherBCBS
FLP00663361OtherRRMC
FL274259400Medicaid
FL30987YMedicare UPIN