Provider Demographics
NPI:1104116391
Name:KHAN, YOUSUF (MD)
Entity type:Individual
Prefix:DR
First Name:YOUSUF
Middle Name:
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 1:3803 W CHESTER PIKE STE 160
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2336
Mailing Address - Country:US
Mailing Address - Phone:484-337-1667
Mailing Address - Fax:
Practice Address - Street 1:1088 W BALTIMORE PIKE STE 2506
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5166
Practice Address - Country:US
Practice Address - Phone:484-234-5000
Practice Address - Fax:484-234-5001
Is Sole Proprietor?:No
Enumeration Date:2011-04-09
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD478323207RE0101X
NC2016-01437207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism