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Contact Information

KHALIL M NASRALLAH, MD
2799 W GRAND BOULEVARD NULL
DETROIT, MI48267-9622
 Phone: 313-916-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
 

Neuromuscular Medicine

2084N0008X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for KHALIL M NASRALLAH · (Male)

NPI # 1619923455
Status Active
Credentials MD
Entity Individual
Enumeration date 05/25/2006
Last updated 07/18/2025 - About 11 months ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301079672
  • MI Medicaid 4877920
  • MI Other 130E26028 BLUE CROSS BLUE SHIELD MI
  • WI Other 34726200 WISCONSIN MEDICAID
Hospital affiliation(s)
  • MCLAREN BAY REGION - (Acute Care)
    1900 COLUMBUS AVE
    BAY CITY, MI 48708
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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