Provider Demographics
NPI:1598943474
Name:KHALEEL, MOHAMMED ALI (DO)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ALI
Last Name:KHALEEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:248-474-1548
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:248-474-1548
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017527207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine