Provider Demographics
NPI:1346287836
Name:NASSAR, HIND S (MD)
Entity Type:Individual
Prefix:
First Name:HIND
Middle Name:S
Last Name:NASSAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067
Mailing Address - Country:US
Mailing Address - Phone:313-930-4177
Mailing Address - Fax:
Practice Address - Street 1:HARPER HOSPITAL PATHOLOGY
Practice Address - Street 2:3990 JOHN R
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2097
Practice Address - Country:US
Practice Address - Phone:313-745-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072633207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0824228Medicare PIN