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General NPI Number Information
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NPI Number | 1982689170
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Entity Type | Individual
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Provider Name | ANNA LUISA DI LORENZO MD
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Gender | Female
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Dates
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Enumeration Date | 12/09/2005
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 2877 CROOKS RD STE B
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City | TROY
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State | MI
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Zip | 48084-4717
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Country | US
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Telephone | 248-822-7003
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Fax | 248-822-7008
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Provider Business Mailing Address
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Address Line | 2877 CROOKS RD STE B
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City | TROY
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State | MI
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Zip | 48084-4717
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Country | US
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Telephone | 248-822-7003
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Fax | 248-822-7008
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301052700
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License Number State | MI
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