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General NPI Number Information
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NPI Number | 1659938785
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Entity Type | Individual
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Provider Name | SURAYA KHALED NAHLAWI DO
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Gender | Female
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR # B1D502
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-615-9016
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Fax |
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Provider Business Mailing Address
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Address Line | 16001 W 9 MILE RD STE 416
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4818
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Country | US
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Telephone | 248-849-8441
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 5101027784
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DO4176
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 38585
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License Number State | NH
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 5151013758
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License Number State | MI
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