Healthcare Provider Details

I. General information

NPI: 1669452140
Provider Name (Legal Business Name): NABIL K WEHBE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44000 W 12 MILE RD SUITE 200
NOVI MI
48377
US

IV. Provider business mailing address

44000 W. TWELVE MILE ROAD SUITE 200
NOVI MI
48377
US

V. Phone/Fax

Practice location:
  • Phone: 248-347-8191
  • Fax: 248-347-8110
Mailing address:
  • Phone: 248-347-8191
  • Fax: 248-305-6857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101008698
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: