Fedoronko, Lori Marcum
Fedoronko, Lori Marcum is an individual health care provider with primary practice located at 1350 Kirts Blvd Suite 155, Troy MI 48084-4851. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Fedoronko, Lori Marcum can be contacted via phone (248) 362-0222.Contact Information
Primary practice address
1350 Kirts Blvd Suite 155
Troy MI 48084-4851
Phone: (248) 362-0222
Fax: (248) 362-1165
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 4301064064 | Michigan |
Profile Details
| NPI number | 1548250855 |
|---|---|
| LBN Legal business name | Fedoronko, Lori Marcum |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Feb 4th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548250855 | NPPES |
| Michigan | MEDICAID | 3415994 |
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