Provider Demographics
NPI:1760610919
Name:KHAN, MOHAMMAD SALMAN (DO)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:SALMAN
Last Name:KHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 23RD ST STE 1200
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-1404
Mailing Address - Country:US
Mailing Address - Phone:330-253-1411
Mailing Address - Fax:330-253-1720
Practice Address - Street 1:701 WHITE POND DR STE 300
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1193
Practice Address - Country:US
Practice Address - Phone:330-253-1411
Practice Address - Fax:330-253-1720
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34011826207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0133833Medicaid
OH0133833Medicaid