Individual
NATHANIEL DAVID LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2799 W GRAND BOULEVARD NULL, DETROIT, MI 48267-0001
(313) 916-2000
Mailing address
5455 N MARGINAL RD APT 436, CLEVELAND, OH 44114-3949
(716) 640-5755
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301514034
MI
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
4301514034
MI
208M00000X
Hospitalist Physician
4301514034
MI
Other
Enumeration date
04/25/2021
Last updated
07/24/2025
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