Provider Demographics
NPI:1568692598
Name:QADAR KHAN MD AND ASSOCIATES,PC
Entity Type:Organization
Organization Name:QADAR KHAN MD AND ASSOCIATES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:QADAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-440-9547
Mailing Address - Street 1:2239 DEER PATH RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-5905
Mailing Address - Country:US
Mailing Address - Phone:215-440-9547
Mailing Address - Fax:
Practice Address - Street 1:702 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-1313
Practice Address - Country:US
Practice Address - Phone:215-947-8329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-24
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033303L261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001488OtherKEYSTONE MERCY
PA0006275620002Medicaid
PA0062756201OtherAMERICHOICE OF PA
PA149580OtherBC BS OF PA
PA02824OtherHEALTH PARTNER
PA1001488OtherKEYSTONE MERCY
PA02824OtherHEALTH PARTNER