Provider Demographics
NPI:1821585001
Name:KHANGURA, CHARANPREET KAUR (DO)
Entity Type:Individual
Prefix:
First Name:CHARANPREET
Middle Name:KAUR
Last Name:KHANGURA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20001 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-3403
Mailing Address - Country:US
Mailing Address - Phone:313-794-5111
Mailing Address - Fax:313-794-5153
Practice Address - Street 1:20001 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3403
Practice Address - Country:US
Practice Address - Phone:313-794-5111
Practice Address - Fax:313-794-5153
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT69010207R00000X, 208M00000X
MI5101026650207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist