Individual
DURENE M ELEM-VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1111 FORT ST, LINCOLN PARK, MI 48146-1802
(313) 386-0000
(313) 386-1597
Mailing address
1111 FORT ST, LINCOLN PARK, MI 48146-1802
(313) 386-0000
(313) 386-1597
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
5901001503
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2710766
—
MI
01
—
4858252150
BLUE CROSS BLUE SHIELD
MI
Enumeration date
05/27/2006
Last updated
09/19/2008
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