Individual
MOHAMMAD IFRAN KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3998 RED LION RD, SUITE 235, PHILADELPHIA, PA 19114-1445
(215) 632-3630
(215) 632-3544
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-6335
(215) 807-8000
(215) 632-3544
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD432688
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023875750001
—
PA
01
—
2131138
HIGHMARK BLUE SHIELD
PA
01
—
30081425
KEYSTONE MERCY
PA
01
—
3739843000
KEYSTONE IBC
PA
01
—
6160713
AETNA
PA
Enumeration date
12/13/2008
Last updated
03/14/2014
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