Mohammed Jamil Ahmed Khan, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

4301031939 Issued in MI

Practice address

1206 Richardson St
Port Huron, MI 48060-3549

Phone

(810) 984-4340

Fax

(810) 984-2303

NPI assigned

Oct 27, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allergy and Asthma Clinic of Michigan PLLC

  • Allergy Physician
  • Southgate, MI
  • NPI 1346774239
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1013907328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603549",
            "telephone_number": "810-984-4340",
            "fax_number": "810-984-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603549",
            "telephone_number": "810-984-4340",
            "fax_number": "810-984-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMED JAMIL",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "4301031939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2108970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Diane Kessinger
• Anthony Key
• KH Seaway Dental PLLC
• Rafia Khalil, MD
• Hira Khan, MD
• Vipul Dharamshi Khanpara, MD
• Leticia Kimpo, M.D.
• Jessica Lynn Kindle
• Heather Lynn King
• James Thomas King Sr., LMSW

• Allergy & Immunology Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.