Individual
GHAITH NAHLAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 ST FRANCIS WAY STE 200, LAFAYETTE, IN 47905-4940
(765) 775-2800
(765) 775-2800
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036115207
IL
207RC0000X
Cardiovascular Disease Physician
Primary
01064491A
IN
207RC0000X
Cardiovascular Disease Physician
01064491C
IN
208M00000X
Hospitalist Physician
01064491A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200911280
—
IN
01
—
P01270969
RR MEDICARE
IN
01
—
P01307691
MEDICARE RR PTAN
IN
Enumeration date
06/30/2006
Last updated
08/15/2023
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