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NPI Code Detail

MEDICARE: DR. SHAHID ALI KHAN D.C.

MEDICARE: DR. SHAHID ALI KHAN D.C.
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
1111N00000XChiropractor2301009421MI
2111NR0400XRehabilitation Chiropractor2301009421MI
3111NX0100XOccupational Health Chiropractor2301009421MI
4111NP0017XPediatric Chiropractor2301009421MI
5111NI0013XIndependent Medical Examiner Chiropractor2301009421MI
6225100000XPhysical Therapist2301009421MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MK009421OTHERMIBCBS OF MI
268504OTHERMIHEALTH PLAN OF MICHIGAN

General Provider Information

NPI Number : 1568609246
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAHID ALI KHAN D.C.
Provider Business Mailing Address
First Line : 27850 GRATIOT AVE
Second Line :
City : ROSEVILLE
State : MI
Zip : 48066-4803
Country : US
Telephone Number : 586-772-5876
Fax Number : 586-772-1122
Provider Business Practice Location Address
First Line : 27850 GRATIOT AVE
Second Line :
City : ROSEVILLE
State : MI
Zip : 48066-4803
Country : US
Telephone Number : 586-772-5876
Fax Number : 586-772-1122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2009
Last Update Date : 06/08/2011

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