MEDICARE: ABBAS ELKHATIB MD PLC

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	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1972465748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABBAS ELKHATIB MD PLC

Provider Business Mailing Address
First Line	:	6635 HERON PT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2060
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6635 HERON PT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-2060
Country	:	US
Telephone Number	:	734-585-4809
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ABBAS EL-KHATIB
Credential	:	MD
Telephone Number	:	734-585-4809

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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