Provider Demographics
NPI:1730102807
Name:KHAN, SHER ZAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHER
Middle Name:ZAMAN
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 1:388 BEN BOLT AVE
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24651-5386
Mailing Address - Country:US
Mailing Address - Phone:276-988-8740
Mailing Address - Fax:276-988-5941
Practice Address - Street 1:388 BEN BOLT AVE
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651
Practice Address - Country:US
Practice Address - Phone:276-988-8740
Practice Address - Fax:276-988-5941
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055209207P00000X
MDD51366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS403890Medicaid
AZ8HZ47QMedicare ID - Type UnspecifiedCHEMI
AS403890Medicaid
AZ8HZ37QMedicare ID - Type UnspecifiedPEACH
AZH46988Medicare UPIN
AZ8HZ17QMedicare ID - Type UnspecifiedPARKER