Doctor Name: | DR. YARA DARWISH NAZZAL |
NPI Number: | 1477845584 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 4301096469 |
Business Practice Address: | 16001 W 9 Mile Rd Southfield, MI - 480754818 |
Business Phone Number: | 2488856697 |
Business Fax Number: | |
Mailing Address: | 22740 Civic Center Dr, SOUTHFIELD |
State: | MI |
Postal Code: | 480337148 |
Phone Number: | 2488856697 |
Fax Number: | |
NPI Enumeration Date: | 05/07/2011 |
NPI Last Update Date: | 05/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301096469 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |