Provider Demographics
NPI:1659891109
Name:KHAN, MOHAMMAD ZIAULLAH HAYAT (DO)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ZIAULLAH HAYAT
Last Name:KHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5033
Mailing Address - Country:US
Mailing Address - Phone:828-315-3360
Mailing Address - Fax:828-315-5228
Practice Address - Street 1:420 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5033
Practice Address - Country:US
Practice Address - Phone:828-315-3360
Practice Address - Fax:828-315-5228
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC259586207R00000X
390200000X
NC2020-03211208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program