Khan, Moniruzzaman
Khan, Moniruzzaman is an sole proprietor health care provider with primary practice located at 4402 E 9 Mile Rd , Warren MI 48091-2590. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Khan, Moniruzzaman can be contacted via phone (586) 200-0611.Contact Information
Primary practice address
4402 E 9 Mile Rd
Warren MI 48091-2590
Phone: (586) 200-0611
Fax: (586) 381-7055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | MK057394 | Michigan |
Profile Details
| NPI number | 1477592905 |
|---|---|
| LBN Legal business name | Khan, Moniruzzaman |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Oct 13th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477592905 | NPPES |
| Other | 0634011 | BCBS | |
| Other | G97370 | BCBS | |
| Other | 1215B | BCBS | |
| Other | 15486 | BCBS | |
| MEDICAID | 414952410 | BCBS | |
| Other | 120911 | BCBS | |
| Other | 6251 | BCBS | |
| Other | P105053 | BCBS | |
| Other | C7543 | BCBS |
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