Individual
MOUNIR KHALED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8944 MACOMB ST, GROSSE ILE, MI 48138-2089
(734) 675-0705
(734) 675-0747
Mailing address
8944 MACOMB ST, GROSSE ILE, MI 48138-2089
(734) 675-0705
(734) 675-0747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301091157
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108298981
BCBS IND
MI
05
—
1760678809
—
MI
Enumeration date
09/22/2007
Last updated
04/15/2011
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