Provider Demographics
NPI:1568774347
Name:KHAN, FARIAH HABIB (DO)
Entity Type:Individual
Prefix:
First Name:FARIAH
Middle Name:HABIB
Last Name:KHAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SAM PERRY BLVD
Mailing Address - Street 2:SUITE 207, TOMPKIN MARTIN MEDICAL PLAZA
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4467
Mailing Address - Country:US
Mailing Address - Phone:540-741-3343
Mailing Address - Fax:540-741-3348
Practice Address - Street 1:1101 SAM PERRY BLVD
Practice Address - Street 2:SUITE 207, TOMPKIN MARTIN MEDICAL PLAZA
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4467
Practice Address - Country:US
Practice Address - Phone:540-741-3343
Practice Address - Fax:540-741-3348
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102202654208M00000X, 207R00000X
MO2021047987208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist