Provider Demographics
NPI:1346745437
Name:KAWAR, LAMA (DO)
Entity Type:Individual
Prefix:DR
First Name:LAMA
Middle Name:
Last Name:KAWAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27050 DOXTATOR ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3336
Mailing Address - Country:US
Mailing Address - Phone:313-703-4113
Mailing Address - Fax:
Practice Address - Street 1:6200 CHASE RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2108
Practice Address - Country:US
Practice Address - Phone:313-278-0600
Practice Address - Fax:313-562-9407
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101026418207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program