MEDICARE: DR. ANWAR J EL-KHATIB PHYSICIAN ASSOCIATE

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	363A00000X	Physician Assistant	5601005669	MI

General Provider Information

NPI Number	:	1275863102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANWAR J EL-KHATIB PHYSICIAN ASSOCIATE

Provider Business Mailing Address
First Line	:	16238 W WARREN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-3701
Country	:	US
Telephone Number	:	313-438-0198
Fax Number	:

Provider Business Practice Location Address
First Line	:	16238 W WARREN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-3701
Country	:	US
Telephone Number	:	313-438-0198
Fax Number	:

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

Provider Enumeration Date	:	12/24/2009
Last Update Date	:	01/29/2026

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