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NPI Code Detail

MEDICARE: AZEEM KHATRI MD

MEDICARE:   AZEEM  KHATRI  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4301514203MI

General Provider Information

NPI Number : 1508595539
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZEEM KHATRI MD
Provider Business Mailing Address
First Line : 26901 BEAUMONT BLVD STE 3D
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48033-3849
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 201 3RD ST
Second Line :
City : BELLEVILLE
State : MI
Zip : 48111-2605
Country : US
Telephone Number : 734-697-9065
Fax Number : 734-697-9049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2022
Last Update Date : 12/17/2025

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