KHALIL M NASRALLAH (NPI# 1619923455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619923455 |
Entity Type | Individual |
Full Name | KHALIL M NASRALLAH |
Credential | MD |
Practice Address |
N10561 Grandview Ln Ironwood MI 49938-9622 |
Mailing Address |
2837 Us 41 West Marquette MI 49855-0220 |
Practice Telephone | 9069322290 |
Mailing Telephone | 9062253964 |
Mailing Fax Number | 9062263875 |
Enumeration Date | 2006-05-25 |
Last Update Date | 2008-03-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
4301079672 | MI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | WISCONSIN MEDICAID | 34726200 | 01 |
MI | BLUE CROSS BLUE SHIELD MI | 130E26028 | 01 |
MI | 4877920 | 05 |
Street Address |
N10561 GRANDVIEW LN |
City | IRONWOOD |
State | MI |
Zip Code | 49938-9622 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588139190 | Nicole Pietsch | Physician Assistant | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2018-10-10 |
1427543750 | Brittany Sue Schneller | Nurse Practitioner | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2018-06-28 |
1699122861 | Aspirus Ironwood Hospital & Clinics, Inc. | Emergency Response System Companies | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2016-05-18 |
1942663877 | Nicole Jeanine Sederholm | Nurse Practitioner | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2016-03-29 |
1316341571 | Kelsey Ladwig | Nurse Anesthetist, Certified Registered | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2014-10-17 |
1639582091 | Aspirus Wausau Hospital, Inc. | Internal Medicine | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2014-06-03 |
1588925101 | Heather Kirsten Nyman | Nurse Practitioner | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2012-05-30 |
1316218639 | Carl Green | Nurse Anesthetist, Certified Registered | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2012-01-18 |
1316220981 | Michelle N Ansley | Nurse Practitioner | N10561 Grandview Ln, Ironwood, MI 49938-9622 | 2011-09-21 |
1437437894 | Carla Marie Loeffler | Physical Therapist | N10561 Grandview Ln, Physical Therapy/rehab Department, Ironwood, MI 49938-9622 | 2011-08-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891319661 | Jonathon Rulseh | Physical Therapy Assistant | 10561 Grandview Ln, Ironwood, MI 49938 | 2020-06-08 |
1295107704 | Susanna Lee Harris | Counselor | 220 Roosevelt St, Ironwood, MI 49938 | 2015-10-22 |
1609214600 | Eve J. Komosa | Physician Assistant | N. 10561 Grand View Lane, Aspirus Grand View, Ironwood, MI 49938 | 2013-06-12 |
1255629861 | Tatyana G Bombard | Radiology | Aspirus Ironwood Hospital, N10561 Grand View Lane, Ironwood, MI 49938 | 2011-07-17 |
1205140761 | Allison Harr | Advanced Practice Midwife | N 10565 Grandview Lane, Ironwood, MI 49938 | 2010-07-27 |
1821267956 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 220 Rooselvelt Street, Ironwood, MI 49938 | 2008-02-22 |
1215106349 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 427 S. Stephenson Avenue, Suite 214, Iron Mountain, MI 49938 | 2008-02-22 |
1740466176 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 10305 Country Club Road, Ironwood, MI 49938 | 2008-01-16 |
1396811121 | Rebecca Lynn Mika | Occupational Therapist | 1310 E Cloverland Dr, Ironwood, MI 49938 | 2006-11-24 |
1306940432 | Marsha Miller Toohey | Chiropractor | 129 E Ayer St, Ironwood, MI 49938 | 2006-09-11 |
Find all providers in zip 49938 |
Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
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1134738545 | Tank Consultation Pllc | Psychiatry & Neurology | 6095 Mcallister Ct Se, Grand Rapids, MI 49546-3836 | 2020-07-31 |
1417578535 | Angelique Maria Manasseh | Psychiatry & Neurology | 28521 Orchard Lake Rd Ste B, Farmington Hills, MI 48334-2934 | 2020-04-29 |
1306473418 | International Medical Clinic Pllc | Psychiatry & Neurology | 26100 American Dr Ste 200, Southfield, MI 48034-2367 | 2020-03-26 |
1720636657 | Muhammad Irshad Khan | Psychiatry & Neurology | 4201 Saint Antoine St Ste Uhc -8d, Detroit, MI 48201-2153 | 2019-09-04 |
1992261481 | Lucid Neurology PC | Psychiatry & Neurology | 26400 W 12 Mile Rd Ste 20, Southfield, MI 48034-1774 | 2019-02-20 |
1417427352 | Ascension St. Mary's Hospital | Psychiatry & Neurology | 4705 Towne Centre Rd Ste 302, Saginaw, MI 48604-2819 | 2018-12-04 |
1205326873 | Montana Neurology Pllc | Psychiatry & Neurology | 2040 Grand River Anx Ste 200, Brighton, MI 48114 | 2018-05-18 |
1508353145 | Kalyan Yarraguntla | Psychiatry & Neurology | 4201 Saint Antoine St # 8c, Detroit, MI 48201-2153 | 2018-04-19 |
1225525389 | Ahmad Ballout | Psychiatry & Neurology | 27358 Michele St, Dearborn Heights, MI 48127-1809 | 2018-04-15 |
1245734730 | E.i. Neurology Associates, Pllc | Psychiatry & Neurology | 15945 19 Mile Rd Ste 106, Clinton Township, MI 48038-1147 | 2018-03-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.