Fulgenzi, Lisa Anne
Fulgenzi, Lisa Anne is an individual health care provider with primary practice located at 26711 Woodward Ave Ste 103 , Huntington Woods MI 48070. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Fulgenzi, Lisa Anne can be contacted via phone (248) 543-6000.Contact Information
Primary practice address
26711 Woodward Ave Ste 103
Huntington Woods MI 48070
Phone: (248) 543-6000
Fax: (248) 543-3770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | LF054789 | Michigan |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | LF054789 | Michigan |
Profile Details
| NPI number | 1962475236 |
|---|---|
| LBN Legal business name | Fulgenzi, Lisa Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Feb 3rd, 2015 - about 9 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 | 1962475236 | NPPES |
| Michigan | MEDICAID | 443604010 |
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