Basic Information
| Provider Information | |||||||||
| NPI: | 1336510072 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEPHRO-CARE MD PLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23010 SHERIDAN ST | ||||||||
| Address2: | |||||||||
| City: | DEARBORN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481281837 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344620340 | ||||||||
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| Practice Location | |||||||||
| Address1: | 19141 GREENFIELD RD | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482356007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1339606605 | ||||||||
| FaxNumber: | 7347539151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2015 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| AuthorizedOfficialLastName: | SAAD | ||||||||
| AuthorizedOfficialFirstName: | CHADI | ||||||||
| AuthorizedOfficialMiddleName: | YOUSSEF | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3136088068 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 4301091025 | MI | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.