IndividualActive
Mazen Khalidi, MD
NPI 1619056041 · Surgery Physician · Saint Clair Shores, MI
Mazen Khalidi, MD is a Surgery Physician provider in Saint Clair Shores, MI (NPI 1619056041).
Provider details
- NPI number
- 1619056041
- Entity type
- Individual
- Primary specialty
- Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 4301034244 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
22790 Harper Ave
Suite C
Saint Clair Shores, MI 48080-1831
Phone: (586) 778-6060
Fax: (586) 773-8220
Street-level locationGet directions
Mailing address
22790 Harper Ave
Saint Clair Shores, MI 48080-1831
Registry dates
- Enumerated
- 2006-11-05
- Last updated
- 2007-07-08
Frequently asked questions
- What is Mazen Khalidi's NPI number?
- Mazen Khalidi's National Provider Identifier (NPI) is 1619056041, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mazen Khalidi's specialty?
- Mazen Khalidi is listed in the NPPES registry with a primary specialty of Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Mazen Khalidi located?
- Mazen Khalidi's practice location on file with NPPES is 22790 Harper Ave, Saint Clair Shores, MI 48080-1831.
- What is Mazen Khalidi's phone number?
- The practice phone number listed in the NPPES registry for Mazen Khalidi is (586) 778-6060.
- Is Mazen Khalidi's NPI active?
- Yes — Mazen Khalidi's NPI (1619056041) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.