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Organization

LINGANORE MEDICAL PRACTICE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAHRUKH KHAN CRNP (OWNER)
(410) 596-0458
Entity
Organization

Contact information

Practice address
1202 E PATRICK ST STE 4, FREDERICK, MD 21701-3167
(410) 596-0458
Mailing address
1202 E PATRICK ST STE 4, FREDERICK, MD 21701-3167

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206054000
MD
01
J356-0011
CAREFIRST BLUECROSS BLUESHIELD
MD
Enumeration date
11/24/2020
Last updated
03/25/2021
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