Provider Demographics
NPI:1518900661
Name:KHEIR, NAGY R (MD)
Entity Type:Individual
Prefix:
First Name:NAGY
Middle Name:R
Last Name:KHEIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6906 CHASE CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3292
Mailing Address - Country:US
Mailing Address - Phone:248-410-4997
Mailing Address - Fax:844-269-7554
Practice Address - Street 1:15000 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-1973
Practice Address - Country:US
Practice Address - Phone:313-245-0649
Practice Address - Fax:313-839-6559
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010787112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1972679678Medicaid