Provider Demographics
NPI:1013350222
Name:KHAN, IKRAM U (MD)
Entity Type:Individual
Prefix:DR
First Name:IKRAM
Middle Name:U
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 1:3006,MARYLAND PARKWAY
Mailing Address - Street 2:SUITE 465
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109
Mailing Address - Country:US
Mailing Address - Phone:702-595-1059
Mailing Address - Fax:702-734-0548
Practice Address - Street 1:3006 S MARYLAND PKWY
Practice Address - Street 2:SUITE 465
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2218
Practice Address - Country:US
Practice Address - Phone:702-595-1059
Practice Address - Fax:702-734-0548
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3635208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery