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Individual

DR. SHAHNOOR ALI KHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
51 STREET OF DREAMS, MARTINSBURG, WV 25403-1134
(304) 264-1442
(304) 264-4317
Mailing address
PO BOX 4056, MARTINSBURG, WV 25402-4056
(703) 400-3433

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20620
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101235819
STATE MEDICAL LICENSE
VA
05
2000700000
WV
01
20620
STATE MEDICAL LICENSE
WV
01
296305
BC ANTHEM
VA
01
D0064888
STATE MEDICAL LICENSE
MD
Enumeration date
09/01/2006
Last updated
12/16/2025
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