Prussack, Lawrence B

Prussack, Lawrence B is an individual health care provider with primary practice located at 6900 Orchard Lake Rd Ste 306, West Bloomfield MI 48322-3405. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Prussack, Lawrence B can be contacted via phone (248) 855-6663.

Contact Information

Primary practice address
6900 Orchard Lake Rd Ste 306 West Bloomfield MI 48322-3405
Phone: (248) 855-6663
Fax: (248) 855-7546
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 4301043881 Michigan

Profile Details

NPI number 1962497248
LBN Legal business name Prussack, Lawrence B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Jan 3rd, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962497248 NPPES
Michigan MEDICAID 2722284

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