Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301090610 | MI |
N | 2080P0203X | Pediatric Critical Care Doctor | 4301090610 | MI |
NPI | 1043410400 |
---|---|
Provider Name | Dr. Ajay Anand Khilanani |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 25/02/2021 |