Provider Demographics
NPI:1427002971
Name:NASRY, SAMER A (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:A
Last Name:NASRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:24230 KARIM BLVD
Mailing Address - Street 2:SUITE#125
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2960
Mailing Address - Country:US
Mailing Address - Phone:248-474-2700
Mailing Address - Fax:248-474-2721
Practice Address - Street 1:24230 KARIM BLVD
Practice Address - Street 2:SUITE#125
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2960
Practice Address - Country:US
Practice Address - Phone:248-474-2700
Practice Address - Fax:248-474-2721
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052864207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF14242Medicare UPIN