Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35090272 | OH |
N | 111NI0900X | Internist | 35090272 | OH |
N | 207RC0000X | Internist - Cardiovascular Disease | MT183557 | PA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 4301093482 | MI |
NPI | 1174715916 |
---|---|
Provider Name | Dr. Mohammad Khalil Kanjwal |
First Address | Lansing, MI 48910-2889 |
Second Address | Lansing, MI 48910-2889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 21/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35090272 | LICENSE (01) | OH |
MT183557 | PA MEDICAL BOARD (01) | PA |