Individual
EUGENIYA KHANUKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15500 19 MILE RD, SUITE 360, CLINTON TOWNSHIP, MI 48038-6330
(586) 263-9999
(586) 263-0581
Mailing address
15500 19 MILE RD, SUITE 360, CLINTON TOWNSHIP, MI 48038-6330
(586) 263-9999
(586) 263-0581
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301048104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4223612
—
MI
Enumeration date
08/03/2006
Last updated
11/19/2008
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