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Organization

PREMIER PHYSICIAN PARTNERS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ADNAN RAHMAN KHAN MD (PRESIDENT)
(703) 282-1796
Entity
Organization

Contact information

Practice address
5859 DONOVAN LN, ELLICOTT CITY, MD 21043-6903
(703) 282-1796
Mailing address
5859 DONOVAN LN, ELLICOTT CITY, MD 21043-6903

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D58291
MD
207ZC0006X
Clinical Pathology Physician
207ZC0500X
Cytopathology Physician
207ZD0900X
Dermatopathology (Pathology) Physician
207ZH0000X
Hematology (Pathology) Physician
207ZM0300X
Medical Microbiology Physician
207ZN0500X
Neuropathology Physician
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
207ZP0101X
Anatomic Pathology Physician
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
207ZP0213X
Pediatric Pathology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10416554
CAQH PROVIDER ID
MD
01
10436137
CAQH PROVIDER ID
MD
01
12542361
CAQH PROVIDER ID
MD
01
12780303
CAQH PROVIDER ID
MD
01
13721023
CAQH PROVIDER ID
MD
Enumeration date
11/24/2017
Last updated
11/24/2017
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