Healthcare Provider Details

I. General information

NPI: 1518900661
Provider Name (Legal Business Name): NAGY R KHEIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 02/17/2024
Certification Date: 02/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15000 GRATIOT AVE
DETROIT MI
48205-1973
US

IV. Provider business mailing address

6906 CHASE CT
WEST BLOOMFIELD MI
48322-3292
US

V. Phone/Fax

Practice location:
  • Phone: 313-245-0649
  • Fax: 313-839-6559
Mailing address:
  • Phone: 248-410-4997
  • Fax: 844-269-7554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301078711
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: