Individual
ASAM KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5900 S LAKE DR, CUDAHY, WI 53110-3171
(414) 689-9000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
63868-21
WI
208M00000X
Hospitalist Physician
Primary
63868
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100045955
—
WI
Enumeration date
06/13/2012
Last updated
07/08/2024
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