Provider Demographics
NPI:1679749626
Name:KHALID, NAUSHABA ISHRATH (MD)
Entity type:Individual
Prefix:DR
First Name:NAUSHABA
Middle Name:ISHRATH
Last Name:KHALID
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Gender:F
Credentials:MD
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Mailing Address - Street 1:17177 N LAUREL PARK DR STE 439
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3938
Mailing Address - Country:US
Mailing Address - Phone:734-462-0340
Mailing Address - Fax:734-462-0344
Practice Address - Street 1:32121 WOODWARD AVE STE 200
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0999
Practice Address - Country:US
Practice Address - Phone:248-690-9946
Practice Address - Fax:248-268-3661
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2021-08-17
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Provider Licenses
StateLicense IDTaxonomies
MI4301091022207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty