Individual
KHALIL M NASRALLAH
Active
Individual
KHALIL M NASRALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
4301079672
MI
2084N0400X
Neurology Physician
Primary
4301079672
MI
2084N0600X
Clinical Neurophysiology Physician
4301079672
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130E26028
BLUE CROSS BLUE SHIELD MI
MI
01
—
34726200
WISCONSIN MEDICAID
WI
05
—
4877920
—
MI
Enumeration date
05/25/2006
Last updated
07/18/2025
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