MEDICARE: GARY THOMAS NEHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	4301061386	MI
2	207P00000X	Emergency Medicine Physician	4301061386	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023088069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY THOMAS NEHER MD

Provider Business Mailing Address
First Line	:	50398 STARLITE RUN
Second Line	:
City	:	NORTHVILLE
State	:	MI
Zip	:	48168-6856
Country	:	US
Telephone Number	:	810-533-2059
Fax Number	:

Provider Business Practice Location Address
First Line	:	159 KERCHEVAL AVE
Second Line	:
City	:	GROSSE POINTE FARMS
State	:	MI
Zip	:	48236-3610
Country	:	US
Telephone Number	:	313-640-2300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	10/14/2021

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Directions to “ GARY THOMAS NEHER MD” Practice Location

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