Provider Demographics
NPI:1396725099
Name:KHAN, UZMA (MD)
Entity type:Individual
Prefix:
First Name:UZMA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1645 ROSTRAVER RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-9655
Mailing Address - Country:US
Mailing Address - Phone:724-929-2640
Mailing Address - Fax:724-929-4308
Practice Address - Street 1:565 COAL VALLEY RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3703
Practice Address - Country:US
Practice Address - Phone:412-267-6810
Practice Address - Fax:412-267-6817
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD417787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008432830001Medicaid
G93475Medicare UPIN
074417K55Medicare ID - Type Unspecified