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1457380800

NPI Code Detail

MEDICARE: GHAITH NAHLAWI MD

MEDICARE: GHAITH NAHLAWI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036115207	IL
2	207RC0000X	Cardiovascular Disease Physician	01064491C	IN
3	208M00000X	Hospitalist Physician	01064491A	IN
4	207RC0000X	Cardiovascular Disease Physician	01064491A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01307691	OTHER	IN	MEDICARE RR PTAN
2	P01270969	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457380800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GHAITH NAHLAWI MD

Provider Business Mailing Address
First Line	:	PO BOX 781076
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48278-1076
Country	:	US
Telephone Number	:	317-528-4800
Fax Number	:	317-865-1479

Provider Business Practice Location Address
First Line	:	3900 ST FRANCIS WAY STE 200
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-4940
Country	:	US
Telephone Number	:	765-775-2800
Fax Number	:	765-775-2800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	08/15/2023

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Directions to “ GHAITH NAHLAWI MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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