Individual
MONIRUZZAMAN KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4402 E 9 MILE RD, WARREN, MI 48091-2590
(586) 200-0611
(586) 381-7055
Mailing address
4402 E 9 MILE RD, WARREN, MI 48091-2590
(586) 200-0611
(586) 381-7055
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MK057394
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0634011
BCBS
—
01
—
120911
CARE CHOICE
—
01
—
1215B
CAPE HEALTH PLAN
—
01
—
15486
HEALTH PLAN OF MICH
—
05
—
414952410
—
MI
01
—
6251
TOTAL HEALTH
—
01
—
C7543
MCARE
—
01
—
G97370
HEALTH ALLIANCE PLAN
—
01
—
P105053
BCN
—
Enumeration date
06/06/2006
Last updated
10/13/2020
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