Provider Demographics
NPI:1477749091
Name:M.A.NAYER, M.D.,P.C.
Entity Type:Organization
Organization Name:M.A.NAYER, M.D.,P.C.
Other - Org Name:TRI-STATE NEUROLOGICAL & SLEEP DISORDER CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-763-5055
Mailing Address - Street 1:PO BOX 22666
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86439-2666
Mailing Address - Country:US
Mailing Address - Phone:928-763-5055
Mailing Address - Fax:928-763-5056
Practice Address - Street 1:3015 HIWAY 95
Practice Address - Street 2:SUITE 109
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-4334
Practice Address - Country:US
Practice Address - Phone:928-763-5055
Practice Address - Fax:928-763-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2084N0400X, 2084N0600X
NV2084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ355009Medicaid
NVV108173Medicare PIN
AZZ118628Medicare PIN