Doctor Name: | MS. LILIA POPADIUK |
NPI Number: | 1003183823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | |
Business Practice Address: | 6071 W Outer Dr Detroit, MI - 482352624 |
Business Phone Number: | 3139930200 |
Business Fax Number: | |
Mailing Address: | 6071 W Outer Dr, DETROIT |
State: | MI |
Postal Code: | 482352624 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/22/2011 |
NPI Last Update Date: | 12/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |