Provider Demographics
NPI:1851409064
Name:KEFRI, MAHER K (MD)
Entity Type:Individual
Prefix:
First Name:MAHER
Middle Name:K
Last Name:KEFRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14555 LEVAN RD
Mailing Address - Street 2:STE 308
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5085
Mailing Address - Country:US
Mailing Address - Phone:248-631-8173
Mailing Address - Fax:734-462-5860
Practice Address - Street 1:414 UNION ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1987
Practice Address - Country:US
Practice Address - Phone:248-631-8173
Practice Address - Fax:248-433-8151
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301055827207RP1001X, 207RP1001X
MI4301088527207RP1001X
FLME118254207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4699022Medicaid
MI4699022Medicaid
MI4283970Medicare PIN