Doctor Name: | LYDIA MARIE LASICHAK |
NPI Number: | 1942284948 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | LL043767 |
Business Practice Address: | 6621 W Maple Rd W Bloomfield, MI - 483223004 |
Business Phone Number: | 2486614700 |
Business Fax Number: | 2486616210 |
Mailing Address: | 6621 W Maple Rd, W BLOOMFIELD |
State: | MI |
Postal Code: | 483222078 |
Phone Number: | 2486614700 |
Fax Number: | 2486616210 |
NPI Enumeration Date: | 12/02/2005 |
NPI Last Update Date: | 12/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RR0500X |
License Number: | LL043767 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Rheumatology |
Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |