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General NPI Number Information
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NPI Number | 1518916147
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Entity Type | Individual
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Provider Name | DEVYANI S KHAMBETE M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 2561 ELIZABETH LAKE RD
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City | WATERFORD
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State | MI
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Zip | 48328-3313
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Country | US
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Telephone | 248-682-3300
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Fax | 248-682-0026
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Provider Business Mailing Address
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Address Line | 2482 WICKFIELD RD
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City | W BLOOMFIELD
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State | MI
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Zip | 48323-3269
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Country | US
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Telephone | 248-682-3300
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Fax | 248-682-0026
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301064393
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License Number State | MI
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