Healthcare Provider Details

I. General information

NPI: 1992994636
Provider Name (Legal Business Name): LILIAN LAI MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 08/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15850 E WARREN AVE
DETROIT MI
48224
US

IV. Provider business mailing address

15850 E WARREN AVE
DETROIT MI
48224
US

V. Phone/Fax

Practice location:
  • Phone: 313-417-0002
  • Fax:
Mailing address:
  • Phone: 313-417-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. JOHN TROTTER
Title or Position: MD
Credential: MD
Phone: 313-417-0002