Individual
MR. KIANOUSH KHAGHANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16151 19 MILE RD, CLINTON TWP, MI 48038-1158
(586) 263-2308
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(734) 457-4030
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301072919
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04232
PARAMOUNT
MI
05
—
104583009
—
MI
01
—
1605802182
BLUE CROSS BLUE SHIELD
MI
01
—
16945
MCARE
MI
01
—
20630
HEALTHPLAN OF MICHIGAN
MI
01
—
7626369
AETNA
MI
01
—
P00215065
RAILROAD MEDICARE
MI
Enumeration date
11/15/2005
Last updated
12/11/2025
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