Provider Demographics
NPI:1720829963
Name:KHAN, HADIYA ALEEM (DPM)
Entity type:Individual
Prefix:DR
First Name:HADIYA
Middle Name:ALEEM
Last Name:KHAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:HADIYA
Other - Middle Name:ALEEM
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:995 CRESTON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-3265
Mailing Address - Country:US
Mailing Address - Phone:586-909-1658
Mailing Address - Fax:
Practice Address - Street 1:33155 ANNAPOLIS ST
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184-2405
Practice Address - Country:US
Practice Address - Phone:734-467-2482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5951001528207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery