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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962475236 NPPES
Michigan MEDICAID 443604010

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