Individual
BASIMA HASAN KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
601 E FRONT AVE STE 401, COEUR D ALENE, ID 83814-5150
(208) 292-4045
Mailing address
601 E FRONT AVE STE 401, COEUR D ALENE, ID 83814-5150
(208) 292-4045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO-06452
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/03/2020
Last updated
08/17/2023
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