Organization
MUKHTAR A KHAN MD,FACC,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKHTAR AHMAD KHAN MD,FACC,CBNC,,PC (OWNER/PHYSICIAN)
(586) 774-0700
Entity
Organization
Contact information
Practice address
25779 KELLY RD, SUITE C, ROSEVILLE, MI 48066-4973
(586) 774-0700
(586) 774-9841
Mailing address
25779 KELLY RD, SUITE C, ROSEVILLE, MI 48066-4973
(586) 774-0700
(586) 774-9841
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MK044345
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2898009
—
MI
Enumeration date
09/01/2006
Last updated
08/22/2020
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