Individual
MBILL SHADMAN KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1332 SOUTHERN DR, STATESBORO, GA 30460-1360
(912) 478-2674
Mailing address
1326 GALE DR, NORCROSS, GA 30093-1615
(470) 269-9509
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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