Individual
INDRYAS LEMMA WOLDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4201 ST. ANTOINE, SUITE 7B, DETROIT, MI 48201-2153
(313) 745-2554
(313) 993-0295
Mailing address
1420 STEPHENSON HWY, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5977
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301088450
MI
207RH0003X
Hematology & Oncology Physician
Primary
4301088450
MI
Other
Enumeration date
05/31/2008
Last updated
05/25/2021
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