Provider Demographics
NPI:1801805494
Name:KHOSLA, SHAUN (MD)
Entity type:Individual
Prefix:
First Name:SHAUN
Middle Name:
Last Name:KHOSLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11701 LIVINGSTON RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-5104
Mailing Address - Country:US
Mailing Address - Phone:301-292-7447
Mailing Address - Fax:301-292-3278
Practice Address - Street 1:11701 LIVINGSTON RD
Practice Address - Street 2:SUITE#105
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-5104
Practice Address - Country:US
Practice Address - Phone:301-292-7447
Practice Address - Fax:301-292-3278
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0068659207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery