Provider Demographics
NPI:1316203367
Name:KHAN, MOHSEN R (DO)
Entity type:Individual
Prefix:
First Name:MOHSEN
Middle Name:R
Last Name:KHAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:9410 CALUMET AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-0018
Mailing Address - Country:US
Mailing Address - Phone:219-922-4900
Mailing Address - Fax:219-836-9922
Practice Address - Street 1:9410 CALUMET AVE STE 401
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-0018
Practice Address - Country:US
Practice Address - Phone:219-922-4900
Practice Address - Fax:219-836-9922
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2025-03-19
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Provider Licenses
StateLicense IDTaxonomies
IN02005502A207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine