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NPI Code Detail

MEDICARE: KAWAR ADVANCED MEDICAL CLINIC PLLC

MEDICARE: KAWAR ADVANCED MEDICAL CLINIC PLLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1538838941
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAWAR ADVANCED MEDICAL CLINIC PLLC
Provider Business Mailing Address
First Line : PO BOX 221
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-0221
Country : US
Telephone Number : 313-278-0600
Fax Number :
Provider Business Practice Location Address
First Line : 6200 CHASE RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-2108
Country : US
Telephone Number : 313-278-0600
Fax Number :
Authorized Official
Title or Position : DELIGATED OFFICIAL
Name : DR. LAMA KAWAR
Credential : DO
Telephone Number : 313-703-4113
Provider Enumeration Date : 09/09/2021
Last Update Date : 09/09/2021

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