Healthcare Provider Details

I. General information

NPI: 1699713982
Provider Name (Legal Business Name): LOIS J AYASH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 JOHN R ST KARMANOS CANCER INST
DETROIT MI
48201-2013
US

IV. Provider business mailing address

1560 E. MAPLE RD SUITE 400-CREDENTIALING
TROY MI
48083-1189
US

V. Phone/Fax

Practice location:
  • Phone: 800-527-6266
  • Fax: 313-576-8767
Mailing address:
  • Phone: 248-581-5976
  • Fax: 248-581-5640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number50625
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4301069385
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: