MUMTAZ J. KHAN (NPI# 1902973985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902973985 |
| Entity Type | Individual |
| Full Name | MUMTAZ J. KHAN |
| Credential | M.D. |
| Practice Address |
Henry Ford Health System 15401 East Jefferson Grosse Pointe Park MI 48230 |
| Practice Telephone | 3138244800 |
| Practice Fax Number | 3138247080 |
| Mailing Telephone | 3138244800 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 4301065423 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BLUE CROSS-BLUE CROSS | 700H262260 | 01 | |
| CHAMPUS-CHAMPUS | MK065423 | 01 | |
| COMMERCIAL-COMMERCIAL NUMBER | MK065423 | 01 | |
| MI | 434035010 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184695280 | Mumtaz A. Khan | Anesthesiology | 750 E Adams St, Syracuse, NY 13210-2306 | 2006-01-28 |
| 1093795726 | Mumtaz Khan | Physician Assistant | 650 Joel Dr, Blanchfield Hospital, Fort Campbell, KY 42223-5318 | 2006-01-19 |
| Street Address |
HENRY FORD HEALTH SYSTEM 15401 EAST JEFFERSON |
| City | GROSSE POINTE PARK |
| State | MI |
| Zip Code | 48230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003976408 | Christian E. George | Ophthalmology | Henry Ford Health System, 15401 E Jefferson, Grosse Pointe Park, MI 48230 | 2006-12-08 |
| 1134297724 | Munther I. Ajlouni | Radiology | Henry Ford Health System, 15401 East Jefferson, Grosse Pointe Park, MI 48230 | 2006-12-01 |
| 1255360335 | Chaitanya Lingam | Internal Medicine | Henry Ford Health System, 15401 East Jefferson, Grosse Pointe Park, MI 48230 | 2006-07-01 |
| 1316975915 | Abdul Rahman Arabi | Internal Medicine | Henry Ford Health System, 15401 East Jefferson, Grosse Pointe Park, MI 48230 | 2006-06-30 |
| 1093788150 | Rashid Alsabeh | Internal Medicine | Henry Ford Health System, 15401 East Jefferson, Grosse Pointe Park, MI 48230 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573450 | Burd Home Health LLC | In Home Supportive Care | 15001 Kerchezal Ave Unit #2042, Grosse Point Park, MI 48230 | 2020-09-16 |
| 1962924886 | Michelle Kathleen Harr | Speech-Language Pathologist | 1356 Bishop Rd, Grosse Pointe Park, MI 48230 | 2017-07-12 |
| 1356711766 | Jerry George Idicula | Behavioral Analyst | 1332 Maryland St, Grosse Pointe Park, MI 48230 | 2015-09-28 |
| 1578939930 | Sierra Gray | Contractor | 890 Cadieux, Grosse Pointe, MI 48230 | 2015-08-19 |
| 1023413853 | Cristovao Bartolo Carreira | Psychologist | 15450 E. Jefferson, Suite 200, Grosse Pointe, MI 48230 | 2014-10-22 |
| 1215217005 | Nui Loa PC | Community/Behavioral Health | 502 Pemberton, Grosse Pointe Park, MI 48230 | 2011-08-24 |
| 1295041846 | Greg Washington LLC | Psychiatry & Neurology | 793 Harcourt, Grosse Pointe Park, MI 48230 | 2010-08-20 |
| 1649445867 | Philip Charles Hessburg | Ophthalmology | 15415 E Jefferson Street, Grosse Pointe Park, MI 48230 | 2008-04-29 |
| 1437289071 | John Boyd Krisel Jr. | Social Worker | 15200 E Jefferson, Suite 105, Grosse Pointe Park, MI 48230 | 2007-03-06 |
| 1346382819 | Robert James Sisler | Social Worker | 15200 East Jefferson, Suite 105, Grosse Pointe Park, MI 48230 | 2007-02-13 |
| Find all providers in zip 48230 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104445980 | Anuja Dharap | Otolaryngology | 35630 Grand River Ave Apt 217, Farmington Hills, MI 48335-3120 | 2020-04-13 |
| 1598311334 | Cogent Medical Group Pllc | Otolaryngology | 28300 Orchard Lake Rd Ste 101, Farmington Hills, MI 48334-3704 | 2019-08-16 |
| 1073025334 | Robert J Stachler Md PC | Otolaryngology | 33200 W. 14 Mile Rd., Ste. 240, West Bloomfield, MI 48322 | 2017-10-26 |
| 1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
| 1174905822 | Scott Jacob Schwartz | Otolaryngology | 6900 Orchard Lake Rd Ste 314, West Bloomfield, MI 48322-3457 | 2015-06-18 |
| 1669868402 | Cameron M Heilbronn | Otolaryngology | 21000 E 12 Mile Rd Ste 111, Saint Clair Shores, MI 48081-1156 | 2015-04-08 |
| 1104230523 | Gary Zachary White | Otolaryngology | 300 North Ave Ste 1400, Battle Creek, MI 49017 | 2014-06-13 |
| 1437574530 | Beacon Medical Group, Inc. | Otolaryngology | 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 | 2014-02-26 |
| 1124361621 | Eric Fahed Succar | Otolaryngology | 44200 Woodward Ave Ste 201, Pontiac, MI 48341-5045 | 2013-04-03 |
| 1396086286 | Nathan Vandjelovic | Otolaryngology | 4201 Saint Antoine St # 9c, Detroit, MI 48201-2153 | 2013-03-03 |
| Find all providers with the same taxonomy | ||||
| City | GROSSE POINTE PARK |
| Zip Code | 48230 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.