Provider Demographics
NPI:1790359792
Name:RIPLEY, LAUREN (DO)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:RIPLEY
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 1:512 MARLIN AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1326
Mailing Address - Country:US
Mailing Address - Phone:269-270-1366
Mailing Address - Fax:
Practice Address - Street 1:DETROIT MEDICAL CENTER
Practice Address - Street 2:4201 ST. ANTOINE
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-966-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program