Healthcare Provider Details

I. General information

NPI: 1568435683
Provider Name (Legal Business Name): NAZIH S ISKANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21751 W 11 MILE RD STE 215
SOUTHFIELD MI
48076-3780
US

IV. Provider business mailing address

21751 W 11 MILE RD STE 215
SOUTHFIELD MI
48076-3780
US

V. Phone/Fax

Practice location:
  • Phone: 248-212-0256
  • Fax: 248-356-3000
Mailing address:
  • Phone: 248-212-0256
  • Fax: 248-356-3000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4301087096
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number4301087096
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: