Provider Demographics
NPI:1801215876
Name:REILLY, LINDSAY FUCHS (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:FUCHS
Last Name:REILLY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4201 SAINT ANTOINE ST
Mailing Address - Street 2:SUITE 6C
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-577-5009
Mailing Address - Fax:313-577-5310
Practice Address - Street 1:751 S BASCOM AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2604
Practice Address - Country:US
Practice Address - Phone:313-577-5009
Practice Address - Fax:313-577-5310
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2021-03-26
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Provider Licenses
StateLicense IDTaxonomies
CAA162915208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery