Khan, Dastagir Alam

Khan, Dastagir Alam is an sole proprietor health care provider with primary practice located at 27 Dyke Rd , Latham NY 12110-1237. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Khan, Dastagir Alam can be contacted via phone (904) 955-7190.

Contact Information

Primary practice address
27 Dyke Rd Latham NY 12110-1237
Phone: (904) 955-7190
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 281049 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 281049 New York

Profile Details

NPI number 1205818911
LBN Legal business name Khan, Dastagir Alam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 17th, 2005
Last updated Jan 17th, 2022 - about 2 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 1205818911 NPPES
New York MEDICAID 04290768
New York MEDICAID 270290800

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