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Organization

MANDARIN OB-GYN PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GHULAM QUADIR KHAN MD (PRESIDENT)
(904) 288-6910
Entity
Organization

Contact information

Practice address
13241 BARTRAM PARK BLVD UNIT 1309, JACKSONVILLE, FL 32258-5229
(904) 288-6910
(904) 288-6916
Mailing address
13241 BARTRAM PARK BLVD UNIT 1309, JACKSONVILLE, FL 32258-5229
(904) 288-6910
(904) 288-6916

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME77915
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
256632000
FL
Enumeration date
09/25/2006
Last updated
01/05/2018
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