Individual provider Active NPI

Khadija Dohadwala

  • Specialist
  • Detroit, MI
National Provider Identifier
1861717407
Registry record updated Apr 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5501014524 Issued in MI
Practice address
5447 Woodward Ave
Detroit, MI 48202-4009
Phone
(313) 832-1100
NPI assigned
Apr 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5501014524 MI Primary

Addresses

Primary practice location

5447 Woodward Ave
Detroit, MI 48202-4009

Mailing address

35135 Pennington Dr
Farmington Hills, MI 48335-2044
Phone (313) 207-4338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5501014524MIMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270512000000",
    "number": "1861717407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35135 PENNINGTON DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352044",
            "telephone_number": "313-207-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5447 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024009",
            "telephone_number": "313-832-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHADWALA",
        "first_name": "KHADIJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "5501014524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; 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.