Individual
DR. ABDUS SALAM KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 MEMORIAL MEDICAL PARKWAY, DAYTONA BEACH, FL 33174-1804
(386) 231-3346
Mailing address
PO BOX 30069, TAMPA, FL 33630-3069
(386) 676-0255
(386) 676-2555
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME-0071027
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000029271
HUMANA UC
FL
01
—
08802
UNIVERAL UC
FL
01
—
10560601
CITRUS INDIVIDUAL
FL
01
—
10560801
CITRUS GROUP UC
FL
01
—
200656648
TAX ID
FL
05
—
251002200
—
FL
01
—
2589619
GHI
FL
05
—
269227900
—
FL
01
—
285718
WELLCARE UC
FL
01
—
289370
AMERIGROUP UC
FL
01
—
295858
AVMED UC
FL
01
—
32566
BCBS INDIVIDUAL
FL
01
—
3535562
AETNA UC
FL
01
—
B903U
BCBS GROUP UC
FL
01
—
DB9962
RR GROUP
FL
01
—
ME0071027
MEDICAL LICENSE
FL
01
—
P00141526
RR INDIVIDUAL
FL
Enumeration date
06/13/2005
Last updated
08/01/2019
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