Individual
MIR YOUSUFUDDIN ALI KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5000
Mailing address
3773 FOXPOINTE DRIVE, ROCKFORD, IL 61114
(630) 290-7220
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301505259
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2018
Last updated
03/10/2023
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