Provider Demographics
NPI:1336232198
Name:LUBETSKY, HARRY S (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:S
Last Name:LUBETSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8599 W. GRAND RIVER AVE.
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-4334
Mailing Address - Country:US
Mailing Address - Phone:810-227-1332
Mailing Address - Fax:
Practice Address - Street 1:8599 W. GRAND RIVER AVE.
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-4334
Practice Address - Country:US
Practice Address - Phone:810-227-1332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIHL030960207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology