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General NPI Number Information
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NPI Number | 1346265816
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Entity Type | Individual
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Provider Name | LORI A. HADDAD D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2151 E 14 MILE RD
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City | BIRMINGHAM
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State | MI
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Zip | 48009-7260
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Country | US
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Telephone | 248-645-0830
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Fax | 248-645-2863
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Provider Business Mailing Address
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Address Line | 2151 E 14 MILE RD
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City | BIRMINGHAM
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State | MI
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Zip | 48009-7260
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Country | US
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Telephone | 248-645-0830
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Fax | 248-645-2863
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | LH0105084
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License Number State | MI
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