Provider Demographics
NPI: | 1134145626 |
---|---|
Name: | NEHME, NADINE (MD) |
Entity Type: | Individual |
Prefix: | |
First Name: | NADINE |
Middle Name: | |
Last Name: | NEHME |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 5943 STADIUM DR |
Mailing Address - Street 2: | |
Mailing Address - City: | KALAMAZOO |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49009-3016 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1521 GULL RD |
Practice Address - Street 2: | |
Practice Address - City: | KALAMAZOO |
Practice Address - State: | MI |
Practice Address - Zip Code: | 49048-1640 |
Practice Address - Country: | US |
Practice Address - Phone: | 269-226-5165 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-07-15 |
Last Update Date: | 2021-12-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | MD00044316 | 208M00000X |
MI | 4301099839 | 208M00000X, 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WA | 0191822 | Other | L&I |
WA | 8410649 | Medicaid | |
MI | 4301099839 | Other | PHYSICIAN LICENSE |
WA | 8939251 | Other | CV |
WA | 8410649 | Medicaid | |
WA | I21352 | Medicare UPIN |