Provider Demographics
NPI:1275790453
Name:NAGLER, WILLIAM
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:NAGLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16311 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-3360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16311 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-3360
Practice Address - Country:US
Practice Address - Phone:734-422-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0440552084B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0002XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB74178Medicare UPIN