Individual
LARA NASSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21000 W 10 MILE RD, SOUTHFIELD, MI 48075-1051
(313) 380-0527
Mailing address
21000 W 10 MILE RD, SOUTHFIELD, MI 48075-1051
(313) 380-0527
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013454
MI
Other
Enumeration date
03/28/2025
Last updated
12/03/2025
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