Individual
DR. KHUDA DAD KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
315 E BROADWAY FL 4, LOUISVILLE, KY 40202
(502) 629-2500
(502) 629-2055
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
01052174A
IN
207RH0003X
Hematology & Oncology Physician
Primary
41517
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200282440
—
IN
05
—
631888
—
AZ
05
—
7100056260
—
KY
01
—
P01190187
MEDICARE RAILROAD
KY
Enumeration date
03/16/2006
Last updated
10/23/2020
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