Organization
ANTIETAM NEUROLOGY CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEHRULLAH KHAN M.D. (PRESIDENT)
(301) 797-1900
Entity
Organization
Contact information
Practice address
11110 MEDICAL CAMPUS RD STE 227, HAGERSTOWN, MD 21742-6727
(301) 797-1900
(301) 797-2238
Mailing address
11110 MEDICAL CAMPUS RD STE 227, HAGERSTOWN, MD 21742-6727
(301) 797-1900
(301) 797-2238
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0022136
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4237013 00
—
MD
Enumeration date
01/24/2007
Last updated
04/27/2010
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