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Individual

JEREMY S KHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
759 PEACHTREE PKWY, SUITE 3, CUMMING, GA 30041-9350
(404) 804-0024
(470) 237-2457
Mailing address
759 PEACHTREE PKWY, SUITE 3, CUMMING, GA 30041-9350
(404) 804-0024
(470) 237-2457

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
054439
GA
207RC0000X
Cardiovascular Disease Physician
Primary
GA054439
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
608617837A
GA
Enumeration date
06/06/2006
Last updated
10/31/2014
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