Healthcare Provider Details
I. General information
NPI: 1225875917
Provider Name (Legal Business Name): ANUSHA KHAN MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/10/2024
Last Update Date: 04/05/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27450 SCHOENHERR RD STE 400
WARREN MI
48088-6684
US
IV. Provider business mailing address
27450 SCHOENHERR RD STE 400
WARREN MI
48088-6684
US
V. Phone/Fax
- Phone: 586-582-7550
- Fax: 586-582-7515
- Phone: 914-484-8257
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174V00000X |
| Taxonomy | Clinical Ethicist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: