Individual
DR. MOHAMMAD A KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
754 CHEROKEE ST NE, SUITE A, MARIETTA, GA 30060-7209
(770) 428-8118
Mailing address
754 CHEROKEE ST NE, SUITE A, MARIETTA, GA 30060-7209
(770) 428-8118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042314
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00728307N
—
GA
01
—
582587211
TAX ID
GA
Enumeration date
03/07/2006
Last updated
12/26/2012
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