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Contact Information

MIRKUTUB M KHAN, MD
4650 JEFFERSON LN NE
ALBUQUERQUE, NM87109-2127
 Phone: 505-727-7900
 Fax: 505-727-7942
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiation Oncology

2085R0001X 92 Physician/Radiation Oncology
Indicates primary specialty

NPI Profile & details for MIRKUTUB M KHAN · (Male)

NPI Number 1588668941
Status Active
Credentials MD
Entity Individual
Enumeration date 06/13/2005
Last updated 10/01/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 77-199
  • NM Medicaid 00023176
  • NM Other 253823 AHCCCS
  • NM Other 920003012 MEDICARE RAILROAD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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