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Individual

LISA ANN PULLUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
6896 S GREENVILLE RD STE 100, GREENVILLE, MI 48838-1081
(616) 754-5036
(616) 754-4380
Mailing address
6896 S GREENVILLE RD STE 100, GREENVILLE, MI 48838-1081
(616) 754-5036
(616) 619-6010

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
5101013172
MI
208VP0014X
Interventional Pain Medicine Physician
Primary
5101013172
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050067089
RAILROAD MEDICARE
01
30230
HEALTH PLAN OF MICHIGAN
01
3743669
CIGNA
05
4802689-11
MI
01
555590041
BCBSM
MI
01
7000027121
PRIORITY HEALTH
MI
01
7000027121
PRIORITY HEALTH MEDICAID
01
7681459
AETNA
Enumeration date
04/12/2006
Last updated
04/02/2025
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