Individual
DR. IMTIAZ AHMAD KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30045-7694
(678) 442-3317
(678) 442-4416
Mailing address
908 ADAIR AVE NE, ATLANTA, GA 30306-3806
(404) 733-6554
(678) 442-4416
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
035077
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00538964D
—
GA
Enumeration date
02/08/2007
Last updated
07/08/2007
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