MEDICARE: ENGY ABUNASSAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	4704335947	MI

General Provider Information

NPI Number	:	1386481992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENGY ABUNASSAR

Provider Business Mailing Address
First Line	:	5143 SHADY CREEK DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-3285
Country	:	US
Telephone Number	:	248-890-8799
Fax Number	:

Provider Business Practice Location Address
First Line	:	5143 SHADY CREEK DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-3285
Country	:	US
Telephone Number	:	248-890-8799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2024
Last Update Date	:	03/11/2026

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