Individual
LISA M COLLETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 2ND FLOOR TAUBMAN CTR RECP F, ANN ARBOR, MI 48109-5332
(734) 936-5738
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301050482
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2820561
—
MI
Enumeration date
10/02/2006
Last updated
03/01/2012
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