Provider Demographics
NPI:1366651903
Name:KAHN, MICHAEL ELLIOT (MED)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ELLIOT
Last Name:KAHN
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 MCCLINTOCK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-5114
Mailing Address - Country:US
Mailing Address - Phone:704-962-8023
Mailing Address - Fax:
Practice Address - Street 1:2132 MCCLINTOCK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-5114
Practice Address - Country:US
Practice Address - Phone:704-962-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2484101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional