Provider Demographics
NPI:1144326042
Name:KAUSER KHAN MD PA
Entity type:Organization
Organization Name:KAUSER KHAN MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAUSER
Authorized Official - Middle Name:FATIMA
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-455-9894
Mailing Address - Street 1:2 W ROLLING CROSSROADS
Mailing Address - Street 2:SUITE # 106
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6208
Mailing Address - Country:US
Mailing Address - Phone:410-455-9894
Mailing Address - Fax:410-455-9846
Practice Address - Street 1:2 W ROLLING CROSSROADS
Practice Address - Street 2:SUITE # 106
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-6208
Practice Address - Country:US
Practice Address - Phone:410-455-9894
Practice Address - Fax:410-455-9846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center