| Canton Medical Clinic | |
|
37662 Ford Rd Westland MI 48185-1924 | |
| (734) 238-3800 | |
| (734) 238-3803 |
| Full Name | Canton Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 37662 Ford Rd, Westland, Michigan |
| Authorized Official Name and Position | Nida Latif (OWNER) |
| Authorized Official Contact | 2695489602 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canton Medical Clinic 37662 Ford Rd Westland MI 48185-1924 Ph: (734) 238-3800 | Canton Medical Clinic 37662 Ford Rd Westland MI 48185-1924 Ph: (734) 238-3800 |
| NPI Number | 1053942060 |
|---|---|
| Provider Enumeration Date | 01/29/2020 |
| Last Update Date | 02/07/2023 |
| Medicare PECOS PAC ID | 5193140333 |
|---|---|
| Medicare Enrollment ID | O20200804003283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053942060 | NPI | - | NPPES |
| 1235144759 | Other | MI | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| Provider Name | Haseeb A Khawaja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679580104 PECOS PAC ID: 6103882642 Enrollment ID: I20130916000755 |
| Provider Name | Nida Latif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235144759 PECOS PAC ID: 2163487471 Enrollment ID: I20170217000266 |
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