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General NPI Number Information
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NPI Number | 1457300899
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Entity Type | Organization
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Legal Business Name | LORICEL ESCOTE MD, PLLC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 30330 W 12 MILE RD SUITE A
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3821
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Country | US
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Telephone | 248-539-1122
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Fax | 248-539-1129
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Provider Business Mailing Address
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Address Line | 30330 W 12 MILE RD SUITE A
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3821
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Country | US
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Telephone | 248-539-1122
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Fax | 248-539-1129
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. LORICEL ESCOTE
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Credential | MD
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Telephone | 248-539-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301067373
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License Number State | MI
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