Provider Demographics
NPI:1902141583
Name:HOJAIJE, KHODR
Entity Type:Individual
Prefix:
First Name:KHODR
Middle Name:
Last Name:HOJAIJE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 MONROE ST STE 103
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2938
Mailing Address - Country:US
Mailing Address - Phone:313-399-0753
Mailing Address - Fax:
Practice Address - Street 1:2012 MONROE ST STE 103
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2938
Practice Address - Country:US
Practice Address - Phone:313-399-0753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver