Healthcare Provider Details

I. General information

NPI: 1710090675
Provider Name (Legal Business Name): MUHAMMAD ABU-SALEH NAYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 HIGHWAY 95 SUITE 109
BULLHEAD CITY AZ
86442-4334
US

IV. Provider business mailing address

3015 HWY 95 SUITE 109
BULLHEAD CITY AZ
86442
US

V. Phone/Fax

Practice location:
  • Phone: 928-763-5055
  • Fax: 928-763-5056
Mailing address:
  • Phone: 928-763-5055
  • Fax: 928-763-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number23706
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number23706
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number12530
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number12530
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: