Organization
EXECUTIVE PLASTIC SURGERY, PLLC
Active
Other names
Crescent Plastic Surgery, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHER W KHAN MD (CEO)
(734) 419-1615
Entity
Organization
Contact information
Practice address
43940 WOODWARD AVE STE 100, BLOOMFIELD HILLS, MI 48302-5025
(734) 419-1615
(248) 934-2185
Mailing address
43940 WOODWARD AVE STE 100, BLOOMFIELD HILLS, MI 48302-5025
(734) 419-1615
(248) 934-2185
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301098160
MI
Other
Enumeration date
10/27/2014
Last updated
03/22/2024
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