Individual
DR. FASEEH UDDIN KHAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1258 W BAY DR STE B, LARGO, FL 33770-2277
(727) 344-6569
(727) 384-4388
Mailing address
5000 PARK ST N STE 1017, ST PETERSBURG, FL 33709-2236
(727) 344-6570
(727) 384-4388
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
ME119805
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012596900
—
FL
01
—
14XM2
BCBS FL
FL
01
—
KX129
MEDICARE
FL
01
—
KX131
MEDICARE
FL
Enumeration date
10/01/2008
Last updated
08/12/2020
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