Provider Demographics
NPI:1629200647
Name:KHAN, ASAD HAMID (MD)
Entity Type:Individual
Prefix:DR
First Name:ASAD
Middle Name:HAMID
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 1:59 DEEP WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-1848
Mailing Address - Country:US
Mailing Address - Phone:304-216-4000
Mailing Address - Fax:
Practice Address - Street 1:927 BEVILLE RD
Practice Address - Street 2:SUITE # 7
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1768
Practice Address - Country:US
Practice Address - Phone:386-269-9009
Practice Address - Fax:386-269-9004
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV182582084F0202X
PAMD070752L2084P0800X
FLME1145282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry