Khan, Moniruzzaman

Khan, Moniruzzaman is an sole proprietor health care provider with primary practice located at 4402 E 9 Mile Rd , Warren MI 48091-2590. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Khan, Moniruzzaman can be contacted via phone (586) 200-0611.

Contact Information

Primary practice address
4402 E 9 Mile Rd Warren MI 48091-2590
Fax: (586) 381-7055
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X MK057394 Michigan

Profile Details

NPI number 1477592905
LBN Legal business name Khan, Moniruzzaman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2006
Last updated Oct 13th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477592905 NPPES
Other 0634011 BCBS
Other G97370 BCBS
Other 1215B BCBS
Other 15486 BCBS
MEDICAID 414952410 BCBS
Other 120911 BCBS
Other 6251 BCBS
Other P105053 BCBS
Other C7543 BCBS

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