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General NPI Number Information
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NPI Number | 1952625360
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Entity Type | Organization
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Legal Business Name | LISA BETH SPECK M.D.P.C.
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 03/15/2010
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Provider Practice Location Address
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Address Line | 32905 W 12 MILE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3342
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Country | US
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Telephone | 248-553-0335
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Fax | 248-553-8945
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Provider Business Mailing Address
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Address Line | 32905 W 12 MILE RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3342
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Country | US
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Telephone | 248-553-0335
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Fax | 248-553-8945
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA BETH SPECK
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Credential | M.D.
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Telephone | 248-553-0335
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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 | LS039813
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License Number State | MI
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