Healthcare Provider Details

I. General information

NPI: 1811053879
Provider Name (Legal Business Name): PREM KHILANANI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44199 DEQUINDRE G10
TROY MI
48085
US

IV. Provider business mailing address

44199 DEQUINDRE G10
TROY MI
48085
US

V. Phone/Fax

Practice location:
  • Phone: 248-964-6111
  • Fax: 248-964-1464
Mailing address:
  • Phone: 248-964-6111
  • Fax: 248-964-1464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberUK037965
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberPK032860
License Number StateMI

VIII. Authorized Official

Name: DR. PREU V KHILANANI
Title or Position: PRESIDENT
Credential: MD
Phone: 248-964-6111