Organization Active NPI

Seemab Gul Khan MD PC

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1083893556
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SEEMAB GUL KHAN MD PC
Practice address
17876 Farmington Rd
BLDG C
Livonia, MI 48152-3104
Phone
(734) 522-1406
Fax
(734) 522-1407
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Authorized official

Name
Mrs. Seemab Gul Khan I, MDNPI 1851485882
Title
President
Phone
(734) 522-1406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

17876 Farmington Rd
BLDG C
Livonia, MI 48152-3104

Mailing address

17876 Farmington Rd
BLDG C
Livonia, MI 48152-3104
Phone (734) 522-1406

Other identifiers 1

IdentifierTypeStateIssuer
4270819MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050929000577 MI Part B Supplier - Clinic/Group Practice 1153378740 Receives reassigned benefits from 1 practitioner
Practice locations: Livonia, MI

National Provider Directory

National Provider Directory

Locations

17876 Farmington Rd
Bldg C
Livonia, MI 48152
Phone (734) 522-1406

9555 Middlebelt Rd
Livonia, MI 48150
Phone (734) 522-1406

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1083893556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17876 FARMINGTON RD",
            "address_2": "BLDG C",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "734-522-1406",
            "fax_number": "734-522-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17876 FARMINGTON RD",
            "address_2": "BLDG C",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "734-522-1406",
            "fax_number": "734-522-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEEMAB GUL KHAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SEEMAB",
        "authorized_official_middle_name": "GUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-522-1406",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4270819",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.