Provider Demographics
NPI:1447868237
Name:CHEAITO, MOHAMAD ABDUL-NABI (RN)
Entity type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:ABDUL-NABI
Last Name:CHEAITO
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 FORD PL STE 3A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:313-874-4806
Mailing Address - Fax:
Practice Address - Street 1:2799 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2689
Practice Address - Country:US
Practice Address - Phone:313-916-1841
Practice Address - Fax:313-916-8270
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2025-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704308635163WC0200X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine