Provider Demographics
NPI:1548782261
Name:KHAN, FAHAD NASEER (MD)
Entity type:Individual
Prefix:
First Name:FAHAD
Middle Name:NASEER
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:794 ROBLE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-9110
Mailing Address - Country:US
Mailing Address - Phone:877-405-4221
Mailing Address - Fax:
Practice Address - Street 1:794 ROBLE RD FL 2
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9110
Practice Address - Country:US
Practice Address - Phone:877-405-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD483884207ZP0102X
NY322644207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology