Provider Demographics
NPI:1942292420
Name:KHANN, MEHREEN BELAL (MD)
Entity Type:Individual
Prefix:
First Name:MEHREEN
Middle Name:BELAL
Last Name:KHANN
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 1:4801 WELDON SPRING PKWY
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-9101
Mailing Address - Country:US
Mailing Address - Phone:800-345-5407
Mailing Address - Fax:636-386-5386
Practice Address - Street 1:4801 WELDON SPRING PKWY
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-9101
Practice Address - Country:US
Practice Address - Phone:800-345-5407
Practice Address - Fax:636-386-5386
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004011001208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1942294240Medicaid
MO1942292420Medicaid
MO1942292420Medicaid