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DR. WISAM KHALIL M.D.
NPI 1407206790
Student in an Organized Health Care Education/Training Program in Brighton, MI

Active since June 16, 2016PECOS Enrolled
7575 GRAND RIVER RD STE 209, BRIGHTON, MI 48114(810) 844-7950 Get Directions Write a Review

NPPES record last updated: June 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Wisam Khalil M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WISAM KHALIL M.D. (NPI 1407206790) is an individual student in an organized health care education/training program in Brighton, Michigan and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407206790
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. WISAM KHALILCredential: M.D.
Location Address7575 GRAND RIVER RD STE 209Brighton, MI 48114-9379
Mailing Address3769 Audrey Rae LnHowell, MI 48843-6604 · (248) 796-2383
Phone(810) 844-7950
Sole ProprietorYes
Enumeration DateJune 16, 2016
✔ NPI 1407206790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
7575 GRAND RIVER RD STE 209, Brighton, MI 48114
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Wisam Khalil M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA ANN GOODENOW MD
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950
SAHAR KHAN MD
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (734) 712-3967
JOSEPH MULLALLY DO
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950
AAFIA MOHAMMED FAROOQ GHEEWALE
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950
PETER YASSA MD
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950
DR. BALAL HUSSAIN M.D.
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950
DR. TRISTAN BRIAN HADLEY MD
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950
PAOULA CHOOBCHIAN MD
Student in an Organized Health Care Education/Training Program
7575 GRAND RIVER RD STE 209
BRIGHTON, MI 48114
Livingston County (810) 844-7950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wisam Khalil's NPI number?

The NPI number for Wisam Khalil is 1407206790. It was assigned to this individual provider in the NPPES registry on June 16, 2016.

Where is Wisam Khalil located?

Wisam Khalil practices at 7575 Grand River Rd Ste 209, Brighton, MI 48114. The listed phone number is (810) 844-7950.

What is Wisam Khalil's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Wisam Khalil enrolled in Medicare?

Yes. Wisam Khalil is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Wisam Khalil was last updated on June 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.