Organization
SKIN AND ALLERGY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSHTAQ AHMAD KHAN (PRESIDENT)
(330) 492-1117
Entity
Organization
Contact information
Practice address
6801 GRAYSTONE CIR NW, DR. KHAN - DERMATOLOGIST, CANTON, OH 44718-1372
(330) 546-0135
(925) 380-8129
Mailing address
6801 GRAYSTONE CIR NW, DR. KHAN - DERMATOLOGIST, CANTON, OH 44718-1372
(330) 546-0135
(925) 380-8129
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35037786
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0350310
—
OH
Enumeration date
05/17/2007
Last updated
04/30/2013
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