Skin and Allergy Clinic, Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35037786 Issued in OH

Legal business name

SKIN AND ALLERGY CLINIC, INC.

Practice address

6801 Graystone Cir NW
Dr. Khan - Dermatologist
Canton, OH 44718-1372

Phone

(330) 546-0135

Fax

(925) 380-8129

NPI assigned

May 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mushtaq Ahmad Khan

Title

President

Phone

(330) 492-1117

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1699982454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 GRAYSTONE CIR NW",
            "address_2": "DR. KHAN - DERMATOLOGIST",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447181372",
            "telephone_number": "330-546-0135",
            "fax_number": "925-380-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 GRAYSTONE CIR NW",
            "address_2": "DR. KHAN - DERMATOLOGIST",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447181372",
            "telephone_number": "330-546-0135",
            "fax_number": "925-380-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN AND ALLERGY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MUSHTAQ",
        "authorized_official_middle_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-492-1117",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35037786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0350310",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Canton, OH
• Providers in Canton, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.