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MELISSA LUKENS DRALLOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1455 S LAPEER RD, SUITE 100, LAKE ORION, MI 48360-1467
(248) 693-3551
Mailing address
1455 S LAPEER RD, SUITE 100, LAKE ORION, MI 48360-1467
(248) 693-3551

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601004538
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08-5-63-1845-0
BCBS MICHIGAN
MI
Enumeration date
06/05/2006
Last updated
07/18/2008
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