Provider Demographics
NPI:1174700504
Name:KHAN, FARAH I (MD)
Entity type:Individual
Prefix:DR
First Name:FARAH
Middle Name:I
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3901 BEAUBIEN ST
Mailing Address - Street 2:5TH FLOOR CARL'S BUILDING, ALLERGY/IMMUNOLOGY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2119
Mailing Address - Country:US
Mailing Address - Phone:313-745-4450
Mailing Address - Fax:313-993-8699
Practice Address - Street 1:3901 BEAUBIEN ST
Practice Address - Street 2:5TH FLOOR CARL'S BUILDING, ALLERGY/IMMUNOLOGY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-745-4450
Practice Address - Fax:313-993-8699
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5315028414207K00000X, 208000000X, 2080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics