Individual
LORI BUBASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6816 VALLEY SPRING RD, BLOOMFIELD, MI 48301-2845
(248) 255-1941
Mailing address
6816 VALLEY SPRING RD, BLOOMFIELD, MI 48301-2845
(248) 255-1941
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301080761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300F362420
BCBSM
MI
05
—
4771321
—
MI
Enumeration date
03/17/2006
Last updated
04/10/2023
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