Provider Demographics
NPI:1609944586
Name:KHAN, AMIR M (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:M
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 THOMSON DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1118
Mailing Address - Country:US
Mailing Address - Phone:434-200-4522
Mailing Address - Fax:
Practice Address - Street 1:1701 THOMSON DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1118
Practice Address - Country:US
Practice Address - Phone:434-200-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101280001207RH0003X
MDD68846207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0003654000Medicaid
TX8H0701OtherBCBS OF TEXAS
TX8H0701OtherBCBS OF TEXAS