Provider Demographics
NPI:1760572150
Name:KHAN, SAADAT ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SAADAT
Middle Name:ALI
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 1:2991 CROUSE LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8833
Mailing Address - Country:US
Mailing Address - Phone:336-586-0994
Mailing Address - Fax:336-586-9363
Practice Address - Street 1:2991 CROUSE LN
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8833
Practice Address - Country:US
Practice Address - Phone:336-586-0994
Practice Address - Fax:336-586-9363
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701005207RP1001X, 207R00000X
NC97-01005207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC17757OtherM.D.
NC20127OtherM.D.
NC290011551OtherM.D.
NC62413OtherM.D.
NC5177OtherM.D.
NC10840OtherM.D.
NC5714193OtherM.D.
NC82229OtherM.D.
NC37256OtherM.D.
NC562106086OtherM.D.
NC263669OtherM.D.
NC4807823OtherM.D.
NC8910840Medicaid
NC5714193OtherM.D.
NC8910840Medicaid