Provider Demographics
NPI:1710963970
Name:KHAIRALLAH, NAJI M (MD)
Entity Type:Individual
Prefix:
First Name:NAJI
Middle Name:M
Last Name:KHAIRALLAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:BOX 42
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-7806
Mailing Address - Fax:269-341-8743
Practice Address - Street 1:451 HEALTH PKWY
Practice Address - Street 2:SUITE F
Practice Address - City:PAW PAW
Practice Address - State:MI
Practice Address - Zip Code:49079-8242
Practice Address - Country:US
Practice Address - Phone:269-655-3080
Practice Address - Fax:269-655-0761
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
MI4301052706207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI238601OtherMEDICARE RURAL HEALTH CLINIC NUMBER
MICA4396OtherRAILROAD MEDICARE
F45843Medicare UPIN
MI238601OtherMEDICARE RURAL HEALTH CLINIC NUMBER
FMM20520049Medicare PIN