Provider Demographics
NPI:1801012323
Name:ENAS NAKKASH, MD PC
Entity type:Organization
Organization Name:ENAS NAKKASH, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT
Authorized Official - Prefix:
Authorized Official - First Name:ANSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KARMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-336-3937
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-0279
Mailing Address - Country:US
Mailing Address - Phone:248-336-3937
Mailing Address - Fax:248-336-3938
Practice Address - Street 1:35200 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4837
Practice Address - Country:US
Practice Address - Phone:586-939-8888
Practice Address - Fax:586-939-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301077105207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty