Provider Demographics
NPI:1902283955
Name:ZUBEDA S KHAN MD PLLC
Entity Type:Organization
Organization Name:ZUBEDA S KHAN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ZUBEDA
Authorized Official - Middle Name:SAIED
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-780-2455
Mailing Address - Street 1:4705 TOWNE CENTRE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-2818
Mailing Address - Country:US
Mailing Address - Phone:989-780-2455
Mailing Address - Fax:
Practice Address - Street 1:4705 TOWNE CENTRE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2818
Practice Address - Country:US
Practice Address - Phone:989-780-2455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072164207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7630851OtherAETNA
MI0991690OtherHEALTH PLUS
MI0731342OtherBCN
MI0731342OtherBCBS
MI4968149Medicaid
MI20080125684769OtherCHAMPS
MI7630851OtherAETNA