Individual
SHAZIA KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1425 HIGHWAY 34 E, NEWNAN, GA 30265-1323
(770) 304-3724
(770) 304-3726
Mailing address
1425 HIGHWAY 34 E, NEWNAN, GA 30265-1323
(770) 304-3724
(770) 304-3726
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
048905
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39BDCFQ
CARRIER PROVIDER NUMBER
GA
01
—
GRP4757
MEDICARE GROUP NUMBER
GA
Enumeration date
09/11/2006
Last updated
10/31/2022
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