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NPI Code Detail

MEDICARE: AMMAR KHANSHOUR M.D.

MEDICARE: AMMAR KHANSHOUR 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
1208M00000XHospitalist Physician4301094034MI
2207R00000XInternal Medicine Physician4301094034MI

General Provider Information

NPI Number : 1447480892
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMMAR KHANSHOUR M.D.
Provider Business Mailing Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-691-8646
Fax Number :
Provider Business Practice Location Address
First Line : 44201 DEQUINDRE RD
Second Line :
City : TROY
State : MI
Zip : 48085-1117
Country : US
Telephone Number : 248-691-8646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2009
Last Update Date : 05/20/2026

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