Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 4301116382 | MI |
NPI | 1013335967 |
---|---|
Provider Name | Adil Khan |
First Address | Southfield, MI 48033-3849 |
Second Address | Royal Oak, MI 48073-6710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2014 |
Last Update Date | 22/10/2020 |