Organization
CENTER FOR PREVENTIVE MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHENIE LUCAS MD (OWNER)
(313) 885-2334
Entity
Organization
Contact information
Practice address
20870 MACK AVE, GROSSE POINTE WOODS, MI 48236-1388
(313) 885-2334
(313) 647-4837
Mailing address
20870 MACK AVE, GROSSE POINTE WOODS, MI 48236-1388
(313) 885-2334
(313) 647-4837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
Other
Enumeration date
09/24/2007
Last updated
05/04/2017
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