Organization
LORI FEDORONKO M D P C
Active
Organization
LORI FEDORONKO M D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI FEDORONKO M D (PRESIDENT)
(248) 362-0222
Entity
Organization
Contact information
Practice address
1350 KIRTS BLVD, SUITE 155, TROY, MI 48084-4851
(248) 362-0222
Mailing address
1350 KIRTS BLVD, SUITE 155, TROY, MI 48084-4851
(248) 362-0222
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
LF064064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3415994
—
MI
Enumeration date
05/29/2007
Last updated
07/01/2016
Update your record
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