Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mazen Khalidi, MD

Individual provider Surgery Physician · NPI 1619056041

Mazen Khalidi, MD is a Surgery Physician in Saint Clair Shores, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

22790 Harper Ave Ste C
Saint Clair Shores, MI 48080-1831
Phone: (586) 778-6060
Fax: (586) 773-8220
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 4301034244 (MI)

Record details

NPI number1619056041
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedNovember 5, 2006
Last updated in NPPESJuly 8, 2007
Mailing address22790 Harper Ave, Suite C, Saint Clair Shores, MI 48080-1831

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