Provider Demographics
NPI:1083619571
Name:KAYALI, NAZIR Y (MD)
Entity type:Individual
Prefix:
First Name:NAZIR
Middle Name:Y
Last Name:KAYALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 UTICA RIDGE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2935
Mailing Address - Country:US
Mailing Address - Phone:563-424-2025
Mailing Address - Fax:563-424-2042
Practice Address - Street 1:5510 UTICA RIDGE RD 100
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2935
Practice Address - Country:US
Practice Address - Phone:563-424-2025
Practice Address - Fax:563-424-2042
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA30840208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0140OtherJOHN DEERE HEALTH PLAN
064909OtherIOWA HEALTH SOLUTIONS
045851OtherHEALTH ALLIANCE
29770OtherWELLMARK BC/BS
IA5180810Medicaid
G32052Medicare UPIN
IA5180810Medicaid