Provider Demographics
NPI:1063447373
Name:TURNER, MADELINE (DO)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1261 S LAPEER ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360
Mailing Address - Country:US
Mailing Address - Phone:248-814-7546
Mailing Address - Fax:248-814-8900
Practice Address - Street 1:1261 S LAPEER ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360
Practice Address - Country:US
Practice Address - Phone:248-814-7546
Practice Address - Fax:248-814-8900
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011132207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0756300995OtherBCBS
MI3182186Medicaid
G14204Medicare UPIN
0P22360Medicare ID - Type Unspecified