Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301079476 | MI |
Y | 111NI0900X | Internist | 4301079476 | MI |
N | 207RH0000X | Hematologist | 4301079476 | MI |
N | 207RX0202X | Medical Oncology | 4301079476 | MI |
NPI | 1407978513 |
---|---|
Provider Name | Gazala Naaz Khan |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 03/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I14823 | (02) | MI |