Individual
MARIAM KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6700
Mailing address
200 RIVERFRONT DR APT 22G, DETROIT, MI 48226-7580
(516) 996-2851
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901600674
MI
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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