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General NPI Number Information
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NPI Number | 1164308839
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Entity Type | Individual
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Provider Name | UMAR KHAN
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Gender | Male
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 850 S MONROE ST
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City | MONROE
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State | MI
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Zip | 48161-1480
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Country | US
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Telephone | 734-457-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 19939 TWIN POND DR
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City | BROWNSTOWN TWP
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State | MI
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Zip | 48183-1166
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Country | US
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Telephone | 734-486-0969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 5302417873
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License Number State | MI
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