Individual
DR. KHAWAJA HAROUN IKRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 SUMMIT AVE STE A, JACKSON, MI 49201-2465
(517) 784-1495
(517) 784-1051
Mailing address
PO BOX 4058, JACKSON, MI 49204-4058
(517) 784-1495
(517) 784-1051
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101010754
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3059100
—
MI
01
—
5380081
BCBS
MI
Enumeration date
10/18/2006
Last updated
03/16/2015
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