Healthcare Provider Details
I. General information
NPI: 1972679678
Provider Name (Legal Business Name): KHEIR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4201 ST ANTOINE BLVD SUITE 3P
DETROIT MI
48201
US
IV. Provider business mailing address
2159 N LOVINGTON APT 202
TROY MI
48083
US
V. Phone/Fax
- Phone: 313-745-3000
- Fax:
- Phone: 248-890-0818
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NAGY
R
KHEIR
Title or Position: OWNER
Credential: M.D.
Phone: 248-890-0818