Provider Demographics
NPI:1821559394
Name:HE, LAUREN JESSICA (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:JESSICA
Last Name:HE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N INGALLS ST STE 7E-07
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-0400
Mailing Address - Country:US
Mailing Address - Phone:734-232-1697
Mailing Address - Fax:734-763-1253
Practice Address - Street 1:300 N INGALLS ST STE 7E-07
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-0400
Practice Address - Country:US
Practice Address - Phone:734-232-1697
Practice Address - Fax:734-763-1253
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-27
Last Update Date:2023-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301508680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program