Organization
FOUR JEWELS HEALTHWAYS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MASOOD N KHAN M.D.,F.A.C.P (PRESIDENT)
(704) 347-0049
Entity
Organization
Contact information
Practice address
320 LILLINGTON AVE, SUITE 201, CHARLOTTE, NC 28204-3130
(704) 347-0049
(704) 347-0979
Mailing address
320 LILLINGTON AVE., SUITE 201, CHARLOTTE, NC 28204
(704) 347-0049
(704) 347-0979
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0220P
BLUE CROSS BLUE SHEILD
NC
05
—
890220P
—
NC
Enumeration date
03/24/2006
Last updated
02/26/2013
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