Khan, Mudussara Asad

Khan, Mudussara Asad is an individual health care provider with primary practice located at 224 Memorial Medical Pkwy Suite 300, Daytona Beach FL 32117-5122. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is her primary health care specialty. Khan, Mudussara Asad can be contacted via phone (386) 231-4060.

Contact Information

Primary practice address
224 Memorial Medical Pkwy Suite 300 Daytona Beach FL 32117-5122
Phone: (386) 231-4060
Fax: (386) 615-9119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X ME114473 Florida
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X ME114473 Florida

Profile Details

NPI number 1821290362
LBN Legal business name Khan, Mudussara Asad
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2007
Last updated Aug 9th, 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 1821290362 NPPES
Florida MEDICAID 008708200

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