NPIMap

Organization Active NPI

Fuad Khaznehkatbi MD PC

  • Specialist
  • Bloomfield Hills, MI
National Provider Identifier
1417276759
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
FK031332 Issued in MI
Legal business name
FUAD KHAZNEHKATBI MD PC
Practice address
43252 Woodward Ave
Suite 100
Bloomfield Hills, MI 48302-5044
Phone
(248) 335-8610
Fax
(248) 335-5942
NPI assigned
May 26, 2010
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Mrs. Patty Reese
Title
Office Manager
Phone
(248) 335-8610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X FK031332 MI Primary

Addresses

Primary practice location

43252 Woodward Ave
Suite 100
Bloomfield Hills, MI 48302-5044

Mailing address

43252 Woodward Ave
Suite 100
Bloomfield Hills, MI 48302-5044
Phone (248) 335-8610

Other identifiers 1

IdentifierTypeStateIssuer
1093111MedicaidMI

National Provider Directory

National Provider Directory

Locations

43252 Woodward Ave
Ste 100
Bloomfld Hls, MI 48302
Phone (248) 335-8610

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1417276759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43252 WOODWARD AVE",
            "address_2": "SUITE 100",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025044",
            "telephone_number": "248-335-8610",
            "fax_number": "248-335-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43252 WOODWARD AVE",
            "address_2": "SUITE 100",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025044",
            "telephone_number": "248-335-8610",
            "fax_number": "248-335-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUAD KHAZNEHKATBI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "REESE",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-335-8610",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "FK031332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.