Provider Demographics
NPI:1457730558
Name:KHAN, SHUMILA
Entity Type:Individual
Prefix:MRS
First Name:SHUMILA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 WAYNE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2986
Mailing Address - Country:US
Mailing Address - Phone:717-261-2546
Mailing Address - Fax:717-263-3614
Practice Address - Street 1:1035 WAYNE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2986
Practice Address - Country:US
Practice Address - Phone:717-261-2546
Practice Address - Fax:717-263-3614
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor