NPI 1003439126

Emily Johanna Lucassian

Practitioner Physician Assistant Clinton Twp, MI

Practice location

Address: 15717 15 Mile Rd, Clinton Twp, MI 48035-2101
Phone: (586) 285-3800
Mailing address: 1 Ford Pl STE 3a, Detroit, MI 48202-3450

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 5601010141 (MI)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003439126
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 May 2020
Record last updated: 3 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.