Larsen, Theresa
Larsen, Theresa is an individual health care provider with primary practice located at 1375 S Lapeer Rd Ste 210, Lake Orion MI 48360-1421. 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. Larsen, Theresa can be contacted via phone (248) 693-5700.Contact Information
Primary practice address
1375 S Lapeer Rd Ste 210
Lake Orion MI 48360-1421
Phone: (248) 693-5700
Fax: (248) 693-5715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301407146 | Michigan |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 4301407146 | Michigan |
Profile Details
| NPI number | 1477551166 |
|---|---|
| LBN Legal business name | Larsen, Theresa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Oct 3rd, 2013 - about 11 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 | 1477551166 | NPPES |
| Michigan | MEDICAID | 3053240 |
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