Provider Demographics
NPI:1407086325
Name:KASSIS AKL, NADER (MD)
Entity Type:Individual
Prefix:
First Name:NADER
Middle Name:
Last Name:KASSIS AKL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-2824
Mailing Address - Country:US
Mailing Address - Phone:517-253-3860
Mailing Address - Fax:517-484-6864
Practice Address - Street 1:1703 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2824
Practice Address - Country:US
Practice Address - Phone:517-253-3860
Practice Address - Fax:517-484-6864
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD450223207RN0300X
MI4301110789207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology