Provider Demographics
NPI:1659759850
Name:KHAN, MOHAMMED ABUZAR (MD)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:ABUZAR
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 1:303 MARILYN WAY
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3295
Mailing Address - Country:US
Mailing Address - Phone:314-475-4754
Mailing Address - Fax:
Practice Address - Street 1:225 S CENTER AVENUE SOMERSET HOSPITAL
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501
Practice Address - Country:US
Practice Address - Phone:814-443-5874
Practice Address - Fax:716-862-1867
Is Sole Proprietor?:No
Enumeration Date:2015-05-08
Last Update Date:2021-08-03
Deactivation Date:2015-12-16
Deactivation Code:
Reactivation Date:2018-08-20
Provider Licenses
StateLicense IDTaxonomies
PAMD464764207R00000X, 208M00000X
CT68918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist