Healthcare Provider Details

I. General information

NPI: 1851409064
Provider Name (Legal Business Name): MAHER K KEFRI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15146 LEVAN RD STE 46
LIVONIA MI
48154-5027
US

IV. Provider business mailing address

15146 LEVAN RD STE 46
LIVONIA MI
48154-5027
US

V. Phone/Fax

Practice location:
  • Phone: 734-744-4562
  • Fax: 734-744-6142
Mailing address:
  • Phone: 734-744-4562
  • Fax: 734-744-6142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4301055827
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number23208180717
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: