Individual
MOHAMMAD I. KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1460 BLUEGRASS AVE, LOUISVILLE, KY 40215-1272
(502) 361-8496
(502) 361-3377
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 361-8496
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
39426
KY
207RH0003X
Hematology & Oncology Physician
Primary
39426
KY
207RX0202X
Medical Oncology Physician
39426
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000481761
ANTHEM
KY
01
—
000000566611
ANTHEM BCBS
KY
05
—
7100010560
—
KY
01
—
P0044417
RAILROAD MEDICARE
KY
Enumeration date
07/11/2006
Last updated
10/21/2021
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