Individual
ADAM M KHANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
260 ELM ST, CUMMING, GA 30040-2467
(470) 758-8573
Mailing address
260 ELM ST, CUMMING, GA 30040-2467
(470) 758-8573
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2023
Last updated
11/05/2024
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