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General NPI Number Information
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NPI Number | 1720829963
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Entity Type | Individual
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Provider Name | HADIYA ALEEM KHAN DPM
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 33155 ANNAPOLIS ST
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City | WAYNE
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State | MI
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Zip | 48184-2405
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Country | US
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Telephone | 734-467-2482
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Fax |
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Provider Business Mailing Address
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Address Line | 995 CRESTON DR
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City | TROY
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State | MI
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Zip | 48085-3265
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Country | US
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Telephone | 586-909-1658
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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 | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 5951001528
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License Number State | MI
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