Individual
SHUJAATALI M KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 JOHN KISSINGER DR, WABASH, IN 46992-1648
(260) 569-2221
(260) 569-2305
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01053702A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200359310
—
IN
Enumeration date
08/01/2006
Last updated
04/10/2023
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