Keinan Taja

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351046170 Issued in MI

Practice address

2 Hurley PLZ Ste 212
Flint, MI 48503-5905

Phone

(810) 262-9080

NPI assigned

Jun 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: ktaja1084104@direct.hfhs.org

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1285250944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6078 FOUNTAIN POINTE APT 3",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397625",
            "telephone_number": "567-204-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HURLEY PLZ STE 212",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035905",
            "telephone_number": "810-262-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJA",
        "first_name": "KEINAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351046170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohammad Jalal Tabbah, M.D
• Steven Courter Taft, D.D.S.
• Isam Tahboub, R.PH., M.S.
• Qurat Ul Ain Tahir
• Tai K. Kang, M.D., P.C.
• Melissa Takacs
• Jacob Talhelm, MD
• Catherine Talley
• Anna Tallon, BS
• Siva Talluri, M.D.

• Student in an Organized Health Care Education/Training Program in Flint, MI
• Providers in Flint, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.