Provider Demographics
NPI:1871989434
Name:SHAH-KHAN, SARDAR MUSA (MD)
Entity type:Individual
Prefix:DR
First Name:SARDAR
Middle Name:MUSA
Last Name:SHAH-KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 AIRPORT GARDENS RD STE 311
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9529
Mailing Address - Country:US
Mailing Address - Phone:606-487-7503
Mailing Address - Fax:606-439-6927
Practice Address - Street 1:429 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2805
Practice Address - Country:US
Practice Address - Phone:304-253-0849
Practice Address - Fax:304-253-1573
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27748207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology