Individual
MOHAMAD KHANSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5220 OAKMAN BLVD, DEARBORN, MI 48126-3318
(313) 581-2121
Mailing address
5220 OAKMAN BLVD, DEARBORN, MI 48126-3318
(313) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301062443
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104272116
—
MI
Enumeration date
06/02/2006
Last updated
12/09/2014
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