Healthcare Provider Details

I. General information

NPI: 1659992303
Provider Name (Legal Business Name): DESIREE ALBANO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 TURF LN
EAST LANSING MI
48823-6392
US

IV. Provider business mailing address

39555 ORCHARD HILL PL STE 600
NOVI MI
48375-5381
US

V. Phone/Fax

Practice location:
  • Phone: 517-484-3000
  • Fax: 517-484-3644
Mailing address:
  • Phone: 517-484-3000
  • Fax: 517-484-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5151014349
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOP61548156
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: