Provider Demographics
NPI:1922236918
Name:LANA KAWA MD PC
Entity Type:Organization
Organization Name:LANA KAWA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:MS
Authorized Official - First Name:LANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-229-2996
Mailing Address - Street 1:4965 ADAMS POINTE CT
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-4111
Mailing Address - Country:US
Mailing Address - Phone:586-979-5100
Mailing Address - Fax:586-795-5050
Practice Address - Street 1:44201 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1117
Practice Address - Country:US
Practice Address - Phone:248-828-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301081236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty