Healthcare Provider Details

I. General information

NPI: 1659305787
Provider Name (Legal Business Name): LANI DEVANEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LANI HUGHES D.O.

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/09/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30205 SCHOENHERR RD SUITE B
WARREN MI
48088-6800
US

IV. Provider business mailing address

HENRY FORD MEDICAL CENTER STERLING HEIGHTS 3500 FIFTEEN MILE ROAD
STERLING HEIGHTS MI
48310
US

V. Phone/Fax

Practice location:
  • Phone: 586-759-7510
  • Fax: 586-759-7791
Mailing address:
  • Phone: 586-977-9932
  • Fax: 586-977-6498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101015607
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: