Provider Demographics
NPI:1760495576
Name:KHURAM KHAN, P.C.
Entity Type:Organization
Organization Name:KHURAM KHAN, P.C.
Other - Org Name:GERMANTOWN RETINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHURAM
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-366-0748
Mailing Address - Street 1:20528 BOLAND FARM RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-4021
Mailing Address - Country:US
Mailing Address - Phone:301-366-0748
Mailing Address - Fax:
Practice Address - Street 1:20528 BOLAND FARM RD
Practice Address - Street 2:SUITE 215
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4021
Practice Address - Country:US
Practice Address - Phone:301-366-0748
Practice Address - Fax:301-355-8649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD-0063863207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty