MEDICARE: DR. JAD GEORGES KHALIL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	4301087573	MI
2	390200000X	Student in an Organized Health Care Education/Training Program		MN
3	207X00000X	Orthopaedic Surgery Physician	55678	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200F311140	OTHER	MI	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124237912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAD GEORGES KHALIL M.D.

Provider Business Mailing Address
First Line	:	26211 CENTRAL PARK BLVD STE 201
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-4158
Country	:	US
Telephone Number	:	248-845-4381
Fax Number	:

Provider Business Practice Location Address
First Line	:	26025 LAHSER RD
Second Line	:	2ND FLOOR
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-2606
Country	:	US
Telephone Number	:	248-663-1900
Fax Number	:	248-663-1901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	04/07/2026

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