Healthcare Provider Details

I. General information

NPI: 1477749091
Provider Name (Legal Business Name): M.A.NAYER, M.D.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

PO BOX 22666
BULLHEAD CITY AZ
86439-2666
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 TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: DR. MUHAMMAD A NAYER
Title or Position: PRESIDENT
Credential: MD
Phone: 928-763-5055