Provider Demographics
NPI:1689845745
Name:KHAN, MARGARET ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-3598
Mailing Address - Country:US
Mailing Address - Phone:715-723-5542
Mailing Address - Fax:715-723-7957
Practice Address - Street 1:2820 E PARK AVE
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-3598
Practice Address - Country:US
Practice Address - Phone:715-723-5542
Practice Address - Fax:715-723-7957
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI38032-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32596400Medicaid
WI32596400Medicaid