Provider Demographics
NPI:1376876102
Name:KHAN, RIZWAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RIZWAN
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47530 ALPINE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-4411
Mailing Address - Country:US
Mailing Address - Phone:734-462-0340
Mailing Address - Fax:734-462-0344
Practice Address - Street 1:4967 CROOKS RD
Practice Address - Street 2:SUITE 130
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-5801
Practice Address - Country:US
Practice Address - Phone:248-952-1601
Practice Address - Fax:248-952-0192
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301094499207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine