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Individual

JILL ALINA LANCASTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
39901 TRADITIONS DR, SUITE 240, NORTHVILLE, MI 48168-9493
(248) 888-9000
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
15584R
LA
208000000X
Pediatrics Physician
Primary
4301088930
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1462837
LA
Enumeration date
06/24/2006
Last updated
08/15/2014
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