Individual
LISA M CORAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2300 HAGGERTY RD STE 2160, WEST BLOOMFIELD, MI 48323-2192
(248) 859-2457
(248) 859-2473
Mailing address
2300 HAGGERTY RD STE 2160, WEST BLOOMFIELD, MI 48323-2192
(248) 859-2457
(248) 859-2473
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5101020468
MI
Other
Enumeration date
06/16/2008
Last updated
04/04/2019
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