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General NPI Number Information
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NPI Number | 1174664866
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Entity Type | Organization
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Legal Business Name | TAWHIDA KHATOON MDPC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5301 MCAULEY DR
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City | YPSILANTI
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State | MI
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Zip | 48197-1051
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Country | US
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Telephone | 734-712-3733
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Fax | 734-712-2719
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Provider Business Mailing Address
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Address Line | 55 E LONG LAKE RD
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City | TROY
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State | MI
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Zip | 48085-4738
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Country | US
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Telephone | 248-390-9507
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Fax | 248-457-9403
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAWHIDA KHATOON
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Credential | M.D.
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Telephone | 248-390-9507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301077926
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License Number State | MI
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