DR. MIRKUTUB M. KHAN (NPI# 1588668941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588668941 |
| Entity Type | Individual |
| Full Name | DR. MIRKUTUB M. KHAN |
| Other Name | DR. KUTUB M. KHAN |
| Credential | M.D. |
| Practice Address |
4650 Jefferson Ln Ne Albuquerque NM 87109-2127 |
| Practice Telephone | 5057277900 |
| Practice Fax Number | 5057277942 |
| Mailing Telephone | 5057277900 |
| Mailing Fax Number | 5057277942 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2015-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
77-199 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 00023176 | 05 | |
| NM | MEDICARE RAILROAD | 920003012 | 01 |
| NM | AHCCCS | 253823 | 01 |
| Street Address |
4650 JEFFERSON LN NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-2127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104075340 | Sarah I Charles | Physician Assistant | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2008-09-11 |
| 1750373692 | Radiation Oncology Associates, P.a. | Radiology | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2005-08-17 |
| 1609877349 | Heyoung L Mcbride | Radiology | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2005-08-03 |
| 1346245594 | Amanda J Story | Radiology | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2005-06-15 |
| 1952306219 | Paul A Anthony | Radiology | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2005-06-14 |
| 1710981147 | Charles D. Stutzman | Radiology | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2005-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114995990 | Cherie Jean Hayostek | Radiology | Msc07-4025, 1 University of New Mexico, Albuquerque, NM 87131-5141 | 2006-03-09 |
| 1306831862 | Ramesh Gopal | Radiology | M. D. Anderson At Presbyterian Kaseman Hospital, 8300 Constitution Ave., Albuquerque, NM 87100 | 2005-09-12 |
| 1134124407 | William Thompson | Radiology | 1201 Camino De Salud Ne, Albuquerque, NM 87102-4517 | 2005-06-14 |
| 1932375805 | Susan Guo | Radiology | 4901 Lang Ave Ne, Albuquerque, NM 87109-4495 | 2008-05-01 |
| 1629280151 | Thomas Mcneil Schroeder | Radiology | 1201 Camino De Salud Ne, Albuquerque, NM 87102-4517 | 2007-05-04 |
| 1629129341 | Amish Ajit Shah | Radiology | 4901 Lang Ave Ne, Albuquerque, NM 87109-4495 | 2007-01-16 |
| 1285727883 | Mary Kara Bucci | Radiology | 8300 Constitution Ave Ne, Albuquerque, NM 87110-7613 | 2006-10-02 |
| 1164475232 | New Mexico Oncology Hematology Consultants, Ltd. | Radiology | 4901 Lang Avenue Ne, Albuquerque, NM 87109 | 2006-05-18 |
| 1124018353 | Gregg E. Franklin | Radiology | 4901 Lang Ave Ne, Albuquerque, NM 87109-4397 | 2005-10-27 |
| 1609877349 | Heyoung L Mcbride | Radiology | 4650 Jefferson Ln Ne, Albuquerque, NM 87109-2127 | 2005-08-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
Please comment or provide details below to improve the information on DR. MIRKUTUB M. KHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.