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Individual

AMTULLAH KHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
112 TRADEPARK DR, SOMERSET, KY 42503-3424
(606) 451-3755
(606) 451-3576
Mailing address
112 TRADEPARK DR, SOMERSET, KY 42503-3424
(606) 451-3755
(606) 451-3576

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
27622
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000220075
ANTHEM PIN
KY
01
043623469
HUMANA PIN
KY
01
2400015
UNITED HEALTHCARE PIN
KY
05
64276223
KY
Enumeration date
07/29/2005
Last updated
05/21/2012
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