Provider Demographics
NPI:1124866892
Name:KHENA, UNKNOWN (MBBS)
Entity type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:KHENA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 ST. ANTOINE ST
Mailing Address - Street 2:SUITE 9C
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2154
Mailing Address - Country:US
Mailing Address - Phone:313-745-5147
Mailing Address - Fax:
Practice Address - Street 1:4201 ST. ANTOINE ST
Practice Address - Street 2:SUITE 9C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2154
Practice Address - Country:US
Practice Address - Phone:313-745-4627
Practice Address - Fax:313-966-7305
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2025-08-06
Deactivation Date:2025-05-12
Deactivation Code:
Reactivation Date:2025-08-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program