Provider Demographics
NPI:1023042769
Name:KHALED H EL-HOSHY MD PC
Entity Type:Organization
Organization Name:KHALED H EL-HOSHY MD PC
Other - Org Name:SOMERSET DERMATOLOGY INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:EL HOSHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-462-9499
Mailing Address - Street 1:14555 LEVAN RD
Mailing Address - Street 2:STE 410
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5085
Mailing Address - Country:US
Mailing Address - Phone:734-462-9499
Mailing Address - Fax:734-462-4124
Practice Address - Street 1:14555 LEVAN RD
Practice Address - Street 2:STE 410
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5085
Practice Address - Country:US
Practice Address - Phone:734-462-9499
Practice Address - Fax:734-462-4124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI070H201340OtherBCBS OF MI
MI070H201340OtherBCBS OF MI