Provider Demographics
NPI:1134169477
Name:KHAN, SAYEED (MD)
Entity type:Individual
Prefix:DR
First Name:SAYEED
Middle Name:
Last Name:KHAN
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:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48303-0432
Mailing Address - Country:US
Mailing Address - Phone:586-755-4333
Mailing Address - Fax:586-755-4744
Practice Address - Street 1:12434 E 12 MILE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3536
Practice Address - Country:US
Practice Address - Phone:586-755-4333
Practice Address - Fax:586-755-4744
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISK072862208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0505014572OtherBLUE CROSS BLUE SHIELD
MI104448069Medicaid
MI0505014572OtherBLUE CROSS BLUE SHIELD
MI104448069Medicaid