Provider Demographics
NPI:1568444677
Name:ISSA, NADHEER (MD)
Entity type:Individual
Prefix:DR
First Name:NADHEER
Middle Name:
Last Name:ISSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44344 DEQUINDRE RD
Mailing Address - Street 2:STE 540
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1042
Mailing Address - Country:US
Mailing Address - Phone:586-997-1230
Mailing Address - Fax:586-991-5476
Practice Address - Street 1:44344 DEQUINDRE RD
Practice Address - Street 2:SUITE 540
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1038
Practice Address - Country:US
Practice Address - Phone:586-997-1230
Practice Address - Fax:586-991-5476
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301074521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4514235Medicaid
H87098Medicare UPIN
M60550006Medicare ID - Type Unspecified