Individual
MR. KHURUM ABBAS KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-1191
(336) 716-8675
(336) 716-5414
Mailing address
900 GRANVILLE DR, WINSTON SALEM, NC 27101-5709
(336) 716-8675
(336) 716-5414
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0002-01942
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002-01942
MEDICAL STATE LICENSE
NC
01
—
150144
NURSING LICENSE
NC
Enumeration date
12/05/2006
Last updated
07/08/2007
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