Provider Demographics
NPI:1912931874
Name:KHAN, SAEEDUDDIN (MD)
Entity Type:Individual
Prefix:
First Name:SAEEDUDDIN
Middle Name:
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 1:3900 LOCH RAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:410-605-7676
Practice Address - Street 1:3901 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218
Practice Address - Country:US
Practice Address - Phone:410-605-7000
Practice Address - Fax:410-605-7598
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061272207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKL90M881OtherPROVIDER NUMBER
712L/239679YBPGMedicare PIN
MDKL90M881OtherPROVIDER NUMBER