Individual
DR. GOHAR SHAMSHAD KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
905 BEVILLE RD, SOUTH DAYTONA, FL 32119-1705
(386) 767-9000
(386) 767-3761
Mailing address
905 BEVILLE RD, SOUTH DAYTONA, FL 32119-1705
(386) 767-9000
(386) 767-3761
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0029698
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067228900
—
FL
Enumeration date
06/17/2005
Last updated
02/26/2016
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