Provider Demographics
NPI:1356557169
Name:KHAN, MAHINUR H (MD)
Entity type:Individual
Prefix:
First Name:MAHINUR
Middle Name:H
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAHIN
Other - Middle Name:H
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11110 MEDICAL CAMPUS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6799
Mailing Address - Country:US
Mailing Address - Phone:301-665-4710
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 130
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6799
Practice Address - Country:US
Practice Address - Phone:301-665-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT179359207RH0003X
MDD91922207RH0003X
PAMD427386207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25-1516376OtherHEALTHNET/TRICARE
PA25-1516376OtherSOUTH CENTRAL PREFERRED
PA9844199OtherAETNA NON-HMO
PA102159201 0001 0002Medicaid
PA1356557169OtherHEALTH AMERICA
PA1888630OtherAETNA HMO
PA25-1516376OtherDEVON
PA25-1516376OtherINTERGROUP
PA248766OtherUNISON
PA25-1516376OtherMULTIPLAN/PHCS
PAMD427386OtherPA MEDICAL LICENSE
PAKH2056189OtherHIGHMARK BLUE SHIELD
PAP00646063OtherRAILROAD MEDICARE
PA1575958OtherGATEWAY
PA25-1516376OtherINFORMED
PA50078615OtherCAPITAL BLUECROSS
PA740109OtherMEDICARE GROUP #
PA740109OtherMEDICARE GROUP #
PA50078615OtherCAPITAL BLUECROSS