Provider Demographics
NPI:1770540205
Name:NOUNA, NABIL (MD)
Entity type:Individual
Prefix:
First Name:NABIL
Middle Name:
Last Name:NOUNA
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 1:305 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-9158
Mailing Address - Country:US
Mailing Address - Phone:269-673-2179
Mailing Address - Fax:269-673-6992
Practice Address - Street 1:305 THOMAS ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9158
Practice Address - Country:US
Practice Address - Phone:269-673-2179
Practice Address - Fax:269-673-6992
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301064273207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110Z310760OtherBLUE CROSS
MI110Z310760OtherBLUE CROSS