Provider Demographics
NPI:1811475478
Name:KHAN, ASMA S (OD)
Entity type:Individual
Prefix:DR
First Name:ASMA
Middle Name:S
Last Name:KHAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4718 MADDIE LN
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-4174
Mailing Address - Country:US
Mailing Address - Phone:773-414-0707
Mailing Address - Fax:
Practice Address - Street 1:26671 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2856
Practice Address - Country:US
Practice Address - Phone:734-458-5181
Practice Address - Fax:734-458-8080
Is Sole Proprietor?:No
Enumeration Date:2018-08-04
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5579152W00000X
IL046.011448152W00000X
MI4901005712152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist