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General NPI Number Information
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NPI Number | 1760656250
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Entity Type | Individual
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Provider Name | MASAKATSU NANAMORI M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1 FORD PL
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City | DETROIT
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State | MI
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Zip | 48202-3450
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Country | US
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Telephone | 313-352-6849
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Fax |
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Provider Business Mailing Address
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Address Line | 26471 GLENWOOD DR
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City | NOVI
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State | MI
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Zip | 48374-2140
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Country | US
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Telephone | 708-856-9382
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C194646
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 4301102510
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 4301102510
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License Number State | MI
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