Provider Demographics
NPI:1992017719
Name:KHAFAGI, AYMAN (MD)
Entity Type:Individual
Prefix:
First Name:AYMAN
Middle Name:
Last Name:KHAFAGI
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 1:404 PERRY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2246
Mailing Address - Country:US
Mailing Address - Phone:231-796-2801
Mailing Address - Fax:231-796-0042
Practice Address - Street 1:404 PERRY AVE STE B
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2246
Practice Address - Country:US
Practice Address - Phone:734-846-4100
Practice Address - Fax:248-286-6571
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096242207P00000X, 207Q00000X
KY47522207P00000X, 207Q00000X, 208M00000X
IN01082826A207P00000X
MI4031096242208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist