Provider Demographics
NPI:1669212452
Name:KHAN, SHAHID HAMID (MD)
Entity type:Individual
Prefix:
First Name:SHAHID
Middle Name:HAMID
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 1:4721 1ST ST SW APT 103
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2706
Mailing Address - Country:US
Mailing Address - Phone:202-913-7442
Mailing Address - Fax:
Practice Address - Street 1:9601 BLACKWELL RD STE 275
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6492
Practice Address - Country:US
Practice Address - Phone:856-955-1247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27809225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health