Provider Demographics
NPI:1740927649
Name:KHAN, SARIM AHMED (MD)
Entity type:Individual
Prefix:
First Name:SARIM
Middle Name:AHMED
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 1:412 E NORTH POINTE DR APT 221
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2342
Mailing Address - Country:US
Mailing Address - Phone:678-464-1333
Mailing Address - Fax:
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:678-464-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-13
Last Update Date:2025-09-02
Deactivation Date:2023-01-13
Deactivation Code:
Reactivation Date:2023-01-25
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0102452208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program