Healthcare Provider Details

I. General information

NPI: 1295014124
Provider Name (Legal Business Name): NEHDIA BADR HASHEMI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2011
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 S HEALTH PKWY
THREE RIVERS MI
49093-8358
US

IV. Provider business mailing address

7595 HAFLINGER CIR
KALAMAZOO MI
49009-3920
US

V. Phone/Fax

Practice location:
  • Phone: 269-279-5240
  • Fax:
Mailing address:
  • Phone: 269-978-0822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301082863
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: