NPIMap

Organization Active NPI

Azmathullah Khan PLLC

  • Pediatrics Physician
  • Dearborn, MI
National Provider Identifier
1265000848
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
AZMATHULLAH KHAN PLLC
Practice address
4700 Greenfield Rd
Dearborn, MI 48126-4124
Phone
(734) 545-0634
Fax
(313) 945-5365
NPI assigned
Jun 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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

Authorized official

Name
Dr. Azmathullah Khan, MDNPI 1073588943
Title
Doctor
Phone
(734) 545-0634

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

4700 Greenfield Rd
Dearborn, MI 48126-4124

Mailing address

4700 Greenfield Rd
Dearborn, MI 48126-4124
Phone (734) 545-0634

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1265000848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "734-545-0634",
            "fax_number": "313-945-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "734-545-0634",
            "fax_number": "313-945-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZMATHULLAH KHAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AZMATHULLAH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "734-545-0634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.