Provider Demographics
NPI:1801892690
Name:KHURANA, MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:KHURANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:25925 TELEGRAPH RD
Mailing Address - Street 2:STE 210
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2527
Mailing Address - Country:US
Mailing Address - Phone:248-746-3218
Mailing Address - Fax:248-746-0369
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:# 30
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-865-4030
Practice Address - Fax:248-865-4031
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301079812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4780151/11Medicaid
MI4780151/11Medicaid
MII36965Medicare UPIN