Basic Information
Provider Information
NPI: 1538379144
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KHAN
FirstName: ARFAAT
MiddleName: MOHAMMED
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 SEAGATE
Address2: STE 800
City: TOLEDO
State: OH
PostalCode: 436041558
CountryCode: US
TelephoneNumber: 5675851918
FaxNumber: 4198247359
Practice Location
Address1: 2799 W GRAND BLVD
Address2:  
City: DETROIT
State: MI
PostalCode: 482022608
CountryCode: US
TelephoneNumber: 3139162417
FaxNumber: 3139168416
Other Information
ProviderEnumerationDate: 05/23/2007
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X4301079585MIY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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