Healthcare Provider Details

I. General information

NPI: 1508961590
Provider Name (Legal Business Name): AMMAR EL NACHEF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29877 TELEGRAPH RD STE 401
SOUTHFIELD MI
48034-7661
US

IV. Provider business mailing address

PO BOX 348
LAPEER MI
48446-0348
US

V. Phone/Fax

Practice location:
  • Phone: 810-814-7827
  • Fax: 810-814-7827
Mailing address:
  • Phone: 810-667-6411
  • Fax: 810-245-7803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301073461
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: