Individual
DR. SAIRA NISHATH KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
28804 GRATIOT AVE, ROSEVILLE, MI 48066-4235
(630) 276-6285
Mailing address
32406 FRANKLIN RD UNIT 250125, FRANKLIN, MI 48025-7004
(630) 276-6285
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
02332
IA
152W00000X
Optometrist
046010925
IL
152W00000X
Optometrist
Primary
4901004366
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7943352
—
MI
01
—
900E03238
BCBS PIN
MI
Enumeration date
10/02/2006
Last updated
06/17/2024
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