Provider Demographics
NPI:1376970293
Name:MOHAMMED A KHALEEL D.O, PLLC
Entity Type:Organization
Organization Name:MOHAMMED A KHALEEL D.O, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:KHALEEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-310-8395
Mailing Address - Street 1:20002 FARMINGTON RD
Mailing Address - Street 2:BUILDING E
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1408
Mailing Address - Country:US
Mailing Address - Phone:248-310-8395
Mailing Address - Fax:
Practice Address - Street 1:20002 FARMINGTON RD
Practice Address - Street 2:BUILDING E
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1408
Practice Address - Country:US
Practice Address - Phone:248-310-8395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty