Individual
GHAZALA MANSOORA KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5333 MCAULEY DR RM 4001, YPSILANTI, MI 48197-1099
(734) 712-3980
Mailing address
5333 MCAULEY DR RM 4001, YPSILANTI, MI 48197-1099
(734) 712-3980
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301503141
MI
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
4301503141
MI
Other
Enumeration date
04/11/2017
Last updated
10/10/2023
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