Healthcare Provider Details

I. General information

NPI: 1699956938
Provider Name (Legal Business Name): M M KHOULANI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 VILLA LINDE PKWY UNIT 4
FLINT MI
48532-3423
US

IV. Provider business mailing address

5080 VILLA LINDE PKWY UNIT 4
FLINT MI
48532-3423
US

V. Phone/Fax

Practice location:
  • Phone: 810-720-5440
  • Fax:
Mailing address:
  • Phone: 810-720-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MOHAMAD MONIR KHOULANI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 810-720-5440