Individual ProviderKazi KhanStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address945 N 12th St, Milwaukee, WI 53233-1305(414) 219-7427(414) 219-7635PECOS EnrollmentBased on the most recent information from CMS, provider Kazi Khan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1659959062Provider TypeIndividualFull NameKhan, KaziTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date3/30/2021Last Updated3/30/2021Contact InformationPractice LocationPractice Address945 N 12th St, Milwaukee, WI 53233-1305Phone(414) 219-7427FaxUnlisted FaxMailing LocationMailing Address945 N 12th St, Milwaukee, WI 53233-1305Phone(414) 219-7635FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer