Individual
DR. MOHAMMAD FARRUKH KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 653-2373
Mailing address
1600 PERRINEVILLE RD STE 2-303, MONROE TOWNSHIP, NJ 08831-4923
(216) 273-9800
(216) 273-9998
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD029897
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01884714
BLUE SHIELD
PA
05
—
1011920410001
—
PA
01
—
1064610
AETNA PPO
PA
01
—
2357937000
KEYSTONE HEALTH PLAN EAST
PA
01
—
30021732
KEYSTONE MERCY
PA
01
—
7542074
AETNA HMO
PA
Enumeration date
10/26/2005
Last updated
08/11/2022
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