Provider Demographics
NPI:1982689170
Name:DI LORENZO, ANNA LUISA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LUISA
Last Name:DI LORENZO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2877 CROOKS RD
Mailing Address - Street 2:STE B
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4717
Mailing Address - Country:US
Mailing Address - Phone:248-822-7003
Mailing Address - Fax:248-822-7008
Practice Address - Street 1:2877 CROOKS RD
Practice Address - Street 2:STE B
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4717
Practice Address - Country:US
Practice Address - Phone:248-822-7003
Practice Address - Fax:248-822-7008
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2007-08-21
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Provider Licenses
StateLicense IDTaxonomies
MI4301052700207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3403090Medicaid
0M43090Medicare ID - Type Unspecified
MI3403090Medicaid