Provider Demographics
NPI:1952628034
Name:KHAN, GALAM ASHEAQUE (MD)
Entity Type:Individual
Prefix:
First Name:GALAM
Middle Name:ASHEAQUE
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 RESERVOIR RD NW # D335
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2126
Mailing Address - Country:US
Mailing Address - Phone:202-687-3512
Mailing Address - Fax:202-687-8935
Practice Address - Street 1:3800 RESERVOIR RD NW
Practice Address - Street 2:DEPT OF PATHOLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2113
Practice Address - Country:US
Practice Address - Phone:202-687-3614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253826207ZN0500X, 208D00000X
RIMD16138207ZN0500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program