Individual ProviderJamal Uddin Azam KhanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address809 82nd Pkwy, Myrtle Beach, SC 29572-4607(843) 692-1595PECOS EnrollmentBased on the most recent information from CMS, provider Jamal Uddin Azam Khan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:05 AM.Profile DetailsProvider ID1205637303Provider TypeIndividualFull NameKhan, Jamal Uddin AzamGenderMaleSole ProprietorNoEnumeration Date3/24/2025Last Updated3/24/2025Contact InformationPractice LocationPractice Address809 82nd Pkwy, Myrtle Beach, SC 29572-4607Phone(843) 692-1595FaxUnlisted FaxMailing LocationMailing Address809 82nd Pkwy, Myrtle Beach, SC 29572-4607Phone(843) 692-1595FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer