Provider Demographics
NPI:1558384693
Name:KHAN, MUHAMMAD ALAMGIR (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:ALAMGIR
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:PO BOX 1108
Mailing Address - Street 2:ATTN: BARB SIMMONS
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-1108
Mailing Address - Country:US
Mailing Address - Phone:734-677-7400
Mailing Address - Fax:734-677-7407
Practice Address - Street 1:940 W AVON RD
Practice Address - Street 2:SUITE 8
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2760
Practice Address - Country:US
Practice Address - Phone:248-651-5600
Practice Address - Fax:248-651-0300
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010522012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F33871OtherBCBS OF MI GROUP PIN
MI2761451Medicaid
MI1306330221OtherBCBS PIN #
F42193Medicare UPIN
MI2761451Medicaid