Provider Demographics
NPI:1407956097
Name:KHANCHANDANI, GEETA N (MD)
Entity Type:Individual
Prefix:DR
First Name:GEETA
Middle Name:N
Last Name:KHANCHANDANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39320 LILLY CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1631
Mailing Address - Country:US
Mailing Address - Phone:248-324-1494
Mailing Address - Fax:
Practice Address - Street 1:39320 LILLY CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1631
Practice Address - Country:US
Practice Address - Phone:248-324-1494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine