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General NPI Number Information
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NPI Number | 1841687894
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Entity Type | Individual
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Provider Name | LAUREN URODA
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Gender | Female
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 23077 GREENFIELD RD STE 190
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3741
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Country | US
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Telephone | 248-554-1116
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Fax | 248-744-3577
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Provider Business Mailing Address
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Address Line | 23077 GREENFIELD RD STE 190
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3741
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Country | US
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Telephone | 248-554-1116
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Fax | 248-744-3577
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5315204163
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License Number State | MI
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