Khan, Ehtisham R.

Khan, Ehtisham R. is an individual health care provider with primary practice located at 8371 Highway 72 W Suite 104, Madison AL 35758-9505. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Khan, Ehtisham R. can be contacted via phone (256) 265-5970.

Contact Information

Primary practice address
8371 Highway 72 W Suite 104 Madison AL 35758-9505
Phone: (256) 265-5970
Fax: (256) 817-5956
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 00019019 Alabama
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 19019 Alabama

Profile Details

NPI number 1417999335
LBN Legal business name Khan, Ehtisham R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Dec 9th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417999335 NPPES
Alabama MEDICAID 009932196
Alabama MEDICAID 109211
Alabama Other 515-96535

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