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NPI Code Detail

MEDICARE: LAUREN SALL M.D.

MEDICARE: LAUREN SALL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician4301502570MI

General Provider Information

NPI Number : 1457733131
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN SALL M.D.
Provider Business Mailing Address
First Line : 4160 JOHN R ST STE 400
Second Line :
City : DETROIT
State : MI
Zip : 48201-2021
Country : US
Telephone Number : 313-745-8773
Fax Number :
Provider Business Practice Location Address
First Line : 3990 JOHN R ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2018
Country : US
Telephone Number : 313-745-7514
Fax Number : 313-745-1873
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2015
Last Update Date : 05/27/2020

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Directions to “ LAUREN SALL M.D.” Practice Location

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