Provider Demographics
NPI:1891249272
Name:LILIAN T LAI MD PLLC
Entity Type:Organization
Organization Name:LILIAN T LAI MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LILIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-745-8453
Mailing Address - Street 1:4201 SAINT ANTOINE ST
Mailing Address - Street 2:2Z DRH UHC
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2153
Mailing Address - Country:US
Mailing Address - Phone:313-745-8453
Mailing Address - Fax:313-745-8162
Practice Address - Street 1:4201 SAINT ANTOINE ST
Practice Address - Street 2:2Z DRH UHC
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:313-745-8453
Practice Address - Fax:313-745-8162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301407145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301407145Medicaid