Provider Demographics
NPI:1659518264
Name:KHAN, ASMA N (DPM)
Entity Type:Individual
Prefix:
First Name:ASMA
Middle Name:N
Last Name:KHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4625 E BAY DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-5738
Mailing Address - Country:US
Mailing Address - Phone:727-434-4468
Mailing Address - Fax:
Practice Address - Street 1:4625 E BAY DR STE 106
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6866
Practice Address - Country:US
Practice Address - Phone:737-550-8401
Practice Address - Fax:904-224-2002
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006030213ES0103X
FLPO4228213ES0103X
VA0103301078213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery