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General NPI Number Information
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NPI Number | 1184826083
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Entity Type | Individual
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Provider Name | LARISA MAY TRAILL M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2007
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 2900 COLLINS RD
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City | LANSING
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State | MI
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Zip | 48910-8394
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Country | US
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Telephone | 517-975-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2280 IVY HILL DR
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City | COMMERCE TOWNSHIP
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State | MI
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Zip | 48382-5122
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Country | US
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Telephone | 347-426-6610
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301086621
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License Number State | MI
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