Provider Demographics
NPI:1972090116
Name:KHAN, MUHAMMAD SHAYAN (MD)
Entity type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:SHAYAN
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:770 W GRANADA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5179
Mailing Address - Country:US
Mailing Address - Phone:386-231-4746
Mailing Address - Fax:386-368-8927
Practice Address - Street 1:3 ADVENTHEALTH WAY STE 130
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-4702
Practice Address - Country:US
Practice Address - Phone:386-586-4765
Practice Address - Fax:386-586-4769
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.147330207RC0000X
FLME175259207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease