Healthcare Provider Details

I. General information

NPI: 1023088069
Provider Name (Legal Business Name): GARY THOMAS NEHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 KERCHEVAL AVE
GROSSE POINTE FARMS MI
48236-3610
US

IV. Provider business mailing address

50398 STARLITE RUN
NORTHVILLE MI
48168-6856
US

V. Phone/Fax

Practice location:
  • Phone: 313-640-2300
  • Fax:
Mailing address:
  • Phone: 810-533-2059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301061386
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301061386
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: