Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301084152 | MI |
N | 111NI0900X | Internist | 4301084152 | MI |
N | 207RC0200X | Critical Care Medicine | 4301084152 | MI |
Y | 207RP1001X | Pulmonary Disease | 4301084152 | MI |
NPI | 1053358549 |
---|---|
Provider Name | Lobelia Samavati |
First Address | Troy, MI 48083-1135 |
Second Address | Detroit, MI 48201-2018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 30/05/2017 |