Individual
FAWAD KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 WALNUT RIDGE DR, HARTLAND, WI 53029-9385
(262) 369-7040
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38768
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32334800
—
WI
Enumeration date
01/12/2006
Last updated
06/05/2024
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