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General NPI Number Information
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NPI Number | 1053329060
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Entity Type | Individual
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Provider Name | LYNN M DONOHUE MD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 3300 E JEFFERSON AVE STE 100
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City | DETROIT
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State | MI
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Zip | 48207-4489
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Country | US
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Telephone | 313-656-1618
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 LAKEVIEW DRIVE
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-2729
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 4301050266
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301050266
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License Number State | MI
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