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General NPI Number Information
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NPI Number | 1659497428
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Entity Type | Organization
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Legal Business Name | KHULLAR MD & ASSOCIATES PLLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 38800 RYAN RD STE 102
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City | STERLING HTS
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State | MI
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Zip | 48310-2993
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Country | US
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Telephone | 586-274-0123
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Fax | 586-274-1125
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Provider Business Mailing Address
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Address Line | 38800 RYAN RD STE 102
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City | STERLING HTS
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State | MI
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Zip | 48310-2993
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Country | US
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Telephone | 586-274-0123
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Fax | 586-274-1125
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Authorized Official
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Title or Position | OWNER
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Name | SUBHASH KHULLAR
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Credential | MD
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Telephone | 586-274-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301040148
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License Number State | MI
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