Provider Demographics
NPI:1659347748
Name:KHAN, MUHAMMAD NAVEED (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:NAVEED
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MUHAMMAD
Other - Middle Name:
Other - Last Name:NAVEED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:211 S CRAPO ST
Mailing Address - Street 2:STE F
Mailing Address - City:MT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2961
Mailing Address - Country:US
Mailing Address - Phone:989-773-2081
Mailing Address - Fax:989-773-3418
Practice Address - Street 1:211 S CRAPO ST
Practice Address - Street 2:STE F
Practice Address - City:MT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2961
Practice Address - Country:US
Practice Address - Phone:989-773-2081
Practice Address - Fax:989-773-3418
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010952812085R0202X, 2085U0001X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34224800Medicaid
065B-15875Medicare ID - Type Unspecified
H71128Medicare UPIN