Provider Demographics
NPI:1740229335
Name:KHAN, MOHAMMED RAFIQ (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:RAFIQ
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:90 WOODRIDGE DR S
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-8327
Mailing Address - Country:US
Mailing Address - Phone:203-324-4568
Mailing Address - Fax:203-579-7436
Practice Address - Street 1:90 WOODRIDGE DR SOUTH
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-579-7300
Practice Address - Fax:203-579-7436
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0367162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG89143Medicare UPIN