Khan, Mirkutub M.
Khan, Mirkutub M. is an individual health care provider with primary practice located at 4650 Jefferson Ln Ne , Albuquerque NM 87109-2127. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Khan, Mirkutub M. can be contacted via phone (505) 727-7900.Contact Information
Primary practice address
4650 Jefferson Ln Ne
Albuquerque NM 87109-2127
Phone: (505) 727-7900
Fax: (505) 727-7942
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | 77-199 | New Mexico |
Profile Details
| NPI number | 1588668941 |
|---|---|
| LBN Legal business name | Khan, Mirkutub M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2005 |
| Last updated | Oct 1st, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588668941 | NPPES |
| New Mexico | Other | 253823 | AHCCCS |
| New Mexico | Other | 920003012 | AHCCCS |
| New Mexico | MEDICAID | 00023176 | AHCCCS |
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