DR. MUDUSSARA ASAD KHAN


Address: 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122
Phone: 3862314060

DR. MUDUSSARA ASAD KHAN (NPI# 1821290362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821290362
Entity Type Individual
Full Name DR. MUDUSSARA ASAD KHAN
Credential MD
Practice Address 224 Memorial Medical Pkwy
Suite 300
Daytona Beach
FL 32117-5122
Mailing Address 4371 Veronica S Shoemaker Blvd
Attn: Credentialing Dept.
Fort Myers
FL 33916-2216
Practice Telephone 3862314060
Practice Fax Number 3866159119
Mailing Telephone 2392748200
Mailing Fax Number 2392783350
Enumeration Date 2007-06-05
Last Update Date 2014-12-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RH0003X Internal Medicine
Specialization: Hematology & Oncology
ME 114473 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 008708200 05

Office Location

Street Address 224 MEMORIAL MEDICAL PKWY
SUITE 300
City DAYTONA BEACH
State FL
Zip Code 32117-5122

Providers in the same location

NPI Name Taxonomy Address Enumeration
1285690529 Karin P Bigman Internal Medicine 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 2006-04-25
1962854281 Jennifer Robinson Dietitian, Registered 224 Memorial Medical Pkwy, Daytona Beach, FL 32117-5111 2016-07-11
1598119943 Cindy Trawick Nurse Practitioner 224 Memorial Medical Pkwy, Daytona Beach, FL 32117-5111 2016-04-21
1063815421 Florida Cancer Specialists & Research Institute, LLC Internal Medicine 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 2014-09-30
1902068158 Eric Michael Harris Internal Medicine 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 2008-06-30
1457300014 Florida Oncology Network Pa Radiology 224 Memorial Medical Pkwy, Daytona Beach, FL 32117-5122 2006-05-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992350409 Erin Selfridge Pharmacist 1500 Beville Rd #300, Daytona Beach, FL 32117 2019-08-02
1881185494 Wellspring Health, LLC Chiropractor 701 Ridgewood Ave, Holly Hills, FL 32117 2018-05-21
1780172791 L & L Db, LLC Clinic/Center 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 2018-04-25
1154837789 Brittany Nikolow Nurse Practitioner 1717 N. Clyde Morris, Daytona Beach, FL 32117 2017-12-19
1205356946 Alejandro Andre Pabon Rodriguez Nurse Anesthetist, Certified Registered Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 2017-06-23
1316492135 Ann Van Herck Physical Therapist 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 2016-08-22
1952784779 Kathryn Brenna Copley Nurse Practitioner 1890 Lpga Blvd., Daytona Beach, FL 32117 2015-06-30
1053719559 Alicia Graham Case Manager/Care Coordinator 1570 Megan Bay Circle, Holly Hill, FL 32117 2014-12-15
1578974440 Halifax Senior Care Inc Clinic/Center 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 2014-05-14
1013345883 Kist Alf, Inc Assisted Living Facility 1516 Carmen Avenue, Daytona Beach, FL 32117 2013-10-14
Find all providers in zip 32117

Taxonomy Information

Taxonomy Code 207RH0003X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Hematology & Oncology

Taxonomy Definition

An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952350548 Murthy V Andavolu Internal Medicine 303 N Clyde Morris Blvd Fl 2, Daytona Beach, FL 32114-2709 2006-05-09
1285690529 Karin P Bigman Internal Medicine 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 2006-04-25
1861627663 Zafar Latif Internal Medicine 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 2009-05-21
1902068158 Eric Michael Harris Internal Medicine 224 Memorial Medical Pkwy, Suite 300, Daytona Beach, FL 32117-5122 2008-06-30
1184726184 Walter James Durkin Internal Medicine 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 2006-09-01
1013019918 Richard Carl Weiss Internal Medicine 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 2006-09-01
1134221070 Boon Yee Chew Internal Medicine 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 2006-09-01
1336241413 Abdul Sorathia Internal Medicine 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 2006-09-01
1780786848 Gregory Favis Internal Medicine 303 N Clyde Morris Blvd, Halifax Regional Oncology Center, Daytona Beach, FL 32114-2709 2006-09-01
1063525491 Hhcsi Halifax Oncology Internal Medicine 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 2006-08-17
Find all providers in DAYTONA BEACH

Competitor

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City DAYTONA BEACH
Zip Code 32117

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Dataset Information

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.

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