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General NPI Number Information
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NPI Number | 1568561959
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Entity Type | Individual
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Provider Name | ARLETHA LENISE ANDERSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 29255 NORTHWESTERN HWY STE 201
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City | SOUTHFIELD
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State | MI
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Zip | 48034-5741
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Country | US
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Telephone | 947-282-8380
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Fax | 947-282-8378
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Provider Business Mailing Address
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Address Line | 29255 NORTHWESTERN HWY STE 201
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City | SOUTHFIELD
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State | MI
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Zip | 48034-5741
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Country | US
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Telephone | 947-282-8380
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Fax | 947-282-8378
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 4301071086
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License Number State | MI
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