Provider Demographics
NPI:1841409067
Name:KHAN, DURRE NAYAB (MD)
Entity Type:Individual
Prefix:
First Name:DURRE
Middle Name:NAYAB
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5483 MOORETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2108
Mailing Address - Country:US
Mailing Address - Phone:757-941-6400
Mailing Address - Fax:
Practice Address - Street 1:1500 N 28TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5332
Practice Address - Country:US
Practice Address - Phone:804-371-1675
Practice Address - Fax:804-225-1764
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012469902084P0800X
VA0116018152390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06115OtherGROUP PTAN