Individual
LAURA FAVAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
3600 FORBES AVENUE, FORBES TOWER - PLAZA LEVEL SUITE 140, PITTSBURGH, PA 15213
(313) 916-2600
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
5101020755
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/02/2013
Last updated
07/22/2020
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