Individual
JONNATHAN OMAR CAZARES LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 WILLIAM CARLS DR, COMMERCE CHARTER TWP, MI 48382
(248) 937-5085
Mailing address
1 WILLIAM CARLS DR, COMMERCE CHARTER TWP, MI 48382
(248) 937-5085
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/10/2024
Last updated
10/02/2024
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