Individual
MRS. SOFIA S KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4501 MACCORKLE AVENUE, SE, CHARLESTON, WV 25304
(304) 925-9225
Mailing address
8 SHANNON PL, CHARLESTON, WV 25314-2100
(304) 346-2289
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19035
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1802112000
—
WV
Enumeration date
11/13/2006
Last updated
08/02/2019
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