Provider Demographics
NPI:1922108521
Name:KHAN, SMEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:SMEENA
Middle Name:
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 1:11801 FOREST HEIGHTS CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2408
Mailing Address - Country:US
Mailing Address - Phone:703-723-9751
Mailing Address - Fax:703-723-9752
Practice Address - Street 1:19455 DEERFIELD AVE
Practice Address - Street 2:SUITE 311
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8100
Practice Address - Country:US
Practice Address - Phone:703-723-9751
Practice Address - Fax:703-723-9752
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235906207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH50422Medicare UPIN