Individual
DR. IMTIAZ A KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4200 E NORTH ST, SUITE 5, GREENVILLE, SC 29615-2437
(864) 292-2266
(864) 292-8356
Mailing address
4416 FOREST DR, 2ND FLOOR, COLUMBIA, SC 29206-3104
(803) 782-4278
(803) 782-3445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
492
SC
Other
Enumeration date
07/03/2006
Last updated
07/08/2007
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