Provider Demographics
NPI:1922449412
Name:KHAN, MARIAM M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:M
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 1:6500 INTERNATIONAL PKWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8226
Mailing Address - Country:US
Mailing Address - Phone:469-276-3660
Mailing Address - Fax:972-870-4915
Practice Address - Street 1:26919 E HWY 380
Practice Address - Street 2:STE 220
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227
Practice Address - Country:US
Practice Address - Phone:940-365-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301102723207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine