Provider Demographics
NPI:1811252547
Name:LAU, JIANMING ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:JIANMING
Middle Name:ALEXANDER
Last Name:LAU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1863
Mailing Address - Fax:
Practice Address - Street 1:201 3RD ST 200
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-2605
Practice Address - Country:US
Practice Address - Phone:734-697-9065
Practice Address - Fax:734-697-9049
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2022-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301101446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5315056434OtherBOARD OF PHARMACY
MI4301101446OtherBOARD OF MEDICINE