Individual ProviderKhalil M KaradshehInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address30701 Woodward Ave, Ste S401, Royal Oak, MI 48073-0987(248) 435-4462PECOS EnrollmentBased on the most recent information from CMS, provider Khalil M Karadsheh does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:21 AM.Profile DetailsProvider ID1487644688Provider TypeIndividualFull NameKaradsheh, Khalil MTitleDr.CredentialMDGenderMaleSole ProprietorYesEnumeration Date10/27/2005Last Updated1/17/2010Contact InformationPractice LocationPractice Address30701 Woodward Ave, Ste S401, Royal Oak, MI 48073-0987Phone(248) 435-4462Fax(248) 435-4094Mailing LocationMailing Address30701 Woodward Ave, Ste S401, Royal Oak, MI 48073-0987Phone(248) 435-4462Fax(248) 435-4094Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4301036025MichiganProvider IdentifiersIDDescriptionIssuerID1356428DescriptionMedicaidIssuerUnlistedMichigan