Provider Demographics
NPI:1003111964
Name:NAKADAR HOSPITALIST GROUP PLLC
Entity Type:Organization
Organization Name:NAKADAR HOSPITALIST GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAQIB
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKADAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-983-4200
Mailing Address - Street 1:37300 DEQUINDRE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3591
Mailing Address - Country:US
Mailing Address - Phone:586-983-4200
Mailing Address - Fax:
Practice Address - Street 1:37300 DEQUINDRE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3591
Practice Address - Country:US
Practice Address - Phone:586-983-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015984207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101015984OtherMICHIGAN STATE LICENSE
MI1538361530Medicaid