Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MK056414 | MI |
NPI | 1003852856 |
---|---|
Provider Name | Dr. Mohamad Monir Khoulani |
First Address | Flint, MI 48532-3411 |
Second Address | Flint, MI 48532-3411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 09/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0250457 | BCN (01) | MI |
0986522 | HEALTHPLUS (01) | MI |
1102504571 | BCBSM (01) | MI |
4136160 | (05) | MI |
900002828 | MEDICARE RAILROAD CARRIER (01) | MI |
C6999 | MCARE (01) | MI |
G27558 | (02) | MI |