Individual
DR. GHAZALI ATAULLAH KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 GRADY ROAD, ETOWAH, TN 37331-0325
(423) 263-2444
(423) 263-1553
Mailing address
PO BOX 325, ETOWAH, TN 37331-0325
(423) 263-2444
(423) 263-1553
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
025977
TN
207RN0300X
Nephrology Physician
025977
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3086308
—
TN
01
—
4031195
BCBS
TN
Enumeration date
04/28/2006
Last updated
11/07/2007
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