MEDICARE: DR. ANN AMMOND LAFOND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	AL043764	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64889B	OTHER	MI	HEALTH ALLIANCE PLAN
2	3899973001	OTHER	MI	CIGNA
3	102494	OTHER	MI	CARE CHOICES
4	4139614	OTHER	MI	AETNA
5	C2791	OTHER	MI	MCARE

General Provider Information

NPI Number	:	1295704815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN AMMOND LAFOND M.D.

Provider Business Mailing Address
First Line	:	8584 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1310
Country	:	US
Telephone Number	:	734-455-4917
Fax Number	:

Provider Business Practice Location Address
First Line	:	8584 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-1310
Country	:	US
Telephone Number	:	734-455-4917
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	02/15/2008

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