Provider Demographics
NPI:1033539846
Name:KHOGALI-JAKARY, NASHWA (DO)
Entity Type:Individual
Prefix:DR
First Name:NASHWA
Middle Name:
Last Name:KHOGALI-JAKARY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:NASHWA
Other - Middle Name:
Other - Last Name:KHOGALI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:3290 W BIG BEAVER RD STE 420
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2931
Mailing Address - Country:US
Mailing Address - Phone:248-649-9700
Mailing Address - Fax:248-649-9745
Practice Address - Street 1:3290 W BIG BEAVER RD STE 420
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2931
Practice Address - Country:US
Practice Address - Phone:248-649-9700
Practice Address - Fax:248-649-9745
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine