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General NPI Number Information
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NPI Number | 1295357721
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Entity Type | Individual
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Provider Name | KASSEM NASSER
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Gender | Male
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Dates
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Enumeration Date | 05/06/2020
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Last Update Date | 05/06/2020
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Provider Practice Location Address
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Address Line | 6048 RAWSONVILLE RD
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-2339
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Country | US
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Telephone | 313-713-2044
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Fax |
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Provider Business Mailing Address
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Address Line | 6018 MIDDLESEX ST
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City | DEARBORN
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State | MI
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Zip | 48126-2115
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Country | US
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Telephone | 313-713-2044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302045211
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License Number State | MI
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