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Organization

HAMTRAMCK PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MONIRUZZAMAN KHAN M.D (PEDIATRICIAN)
(313) 366-4000
Entity
Organization

Contact information

Practice address
12033 CONANT ROAD, HAMTRAMCK, MI 48212
(313) 366-4000
(313) 366-4001
Mailing address
12033 CONANT ROAD, HAMTRAMCK, MI 48212
(313) 366-4000
(313) 366-4001

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301057394
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4149524
MI
01
G97370
HAP UPIN NUMBER
MI
Enumeration date
03/31/2011
Last updated
02/07/2012
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