Organization Active NPI

Nabil Metwally MD PC

  • Internal Medicine Physician
  • Redford, MI
National Provider Identifier
1922116128
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301064169 Issued in MI
Legal business name
NABIL METWALLY MD PC
Practice address
24224 Joy Rd
Suite 101
Redford, MI 48239-1215
Phone
(313) 565-6663
Fax
(313) 565-6632
NPI assigned
Aug 28, 2006
Last updated
Jul 13, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nabil M Metwally, MDNPI 1477591139
Title
Owner
Phone
(313) 565-6663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301064169 MI Primary

Addresses

Primary practice location

24224 Joy Rd
Suite 101
Redford, MI 48239-1215

Mailing address

39353 Heatherbrook Dr
Farmington Hills, MI 48331-2918
Phone (313) 565-6663

Other identifiers 1

IdentifierTypeStateIssuer
1922116128MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061228000079 MI Part B Supplier - Clinic/Group Practice 1951301886 Receives reassigned benefits from 6 practitioners
Practice locations: Wyandotte, MI; West Bloomfield, MI; Wayne, MI; Trenton, MI; Taylor, MI; Southfield, MI; Redford, MI; Livonia, MI…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0982174Nabil Metwally, MD, PC24224 Joy Road, Suite 101, Redford, MI 48239Certificate of waiverJan 17, 2027

National Provider Directory

National Provider Directory

Locations

8550 N Silvery Ln
Ste 400
Dearborn Heights, MI 48127
Phone (313) 565-6663

46325 W Twelve Mile Rd
Ste 235
Novi, MI 48377
Phone (248) 305-6154

24224 Joy Rd
Ste 101
Redford, MI 48239
Phone (248) 305-6154

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1922116128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39353 HEATHERBROOK DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312918",
            "telephone_number": "313-565-6663",
            "fax_number": "313-565-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24224 JOY RD",
            "address_2": "SUITE 101",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391215",
            "telephone_number": "313-565-6663",
            "fax_number": "313-565-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NABIL METWALLY MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "METWALLY",
        "authorized_official_first_name": "NABIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-565-6663",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301064169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922116128",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.