Individual
MAHVISH M KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1325 WYOMING BLVD NE, ALBUQUERQUE, NM 87112-5046
(505) 291-5300
(505) 291-5302
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
C7-0006401
DE
2084P0800X
Psychiatry Physician
Primary
MD2020-0946
NM
2084P0800X
Psychiatry Physician
RS2018-0388
NM
Other
Enumeration date
02/01/2017
Last updated
08/11/2021
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