Provider Demographics
NPI:1013448216
Name:KHAN, FARID MANSOOR (MD)
Entity type:Individual
Prefix:
First Name:FARID
Middle Name:MANSOOR
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1701 OLD VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3772
Mailing Address - Country:US
Mailing Address - Phone:828-693-1773
Mailing Address - Fax:828-692-3297
Practice Address - Street 1:1701 OLD VILLAGE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3772
Practice Address - Country:US
Practice Address - Phone:828-693-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-03490207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty