Individual
ANDREISE LAURIAN NAZZARIA ROSA DE SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30695 LITTLE MACK AVE STE 200, ROSEVILLE, MI 48066-1781
(586) 294-9600
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301511970
MI
Other
Enumeration date
06/14/2022
Last updated
10/06/2025
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