Individual
MUMTAJ A. KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11879 QUARTERHORSE CT, CINCINNATI, OH 45249-1280
(513) 257-3882
Mailing address
11879 QUARTERHORSE CT, CINCINNATI, OH 45249-1280
(513) 257-3882
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35-04-1818 K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000264612
BLUECROSS BLUESHIELD
OH
05
—
0404600
—
OH
Enumeration date
01/25/2006
Last updated
07/08/2007
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