Provider Demographics
NPI:1871783662
Name:HALA NAHHAS, M.D., PLLC
Entity type:Organization
Organization Name:HALA NAHHAS, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:HALA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAHHAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-675-5554
Mailing Address - Street 1:43700 WOODWARD AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5058
Mailing Address - Country:US
Mailing Address - Phone:248-221-5170
Mailing Address - Fax:313-563-3330
Practice Address - Street 1:43700 WOODWARD AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5058
Practice Address - Country:US
Practice Address - Phone:248-221-5170
Practice Address - Fax:313-441-2488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010779992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP4909Medicare PIN