Individual
MR. LLOYD DEAN INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2045 ASHER CT, EAST LANSING, MI 48823-8444
(517) 332-0285
(517) 332-0356
Mailing address
2045 ASHER CT, EAST LANSING, MI 48823-8444
(517) 332-0285
(517) 332-0356
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326133398
TAX ID# 383348654
MI
Enumeration date
06/19/2009
Last updated
06/19/2009
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