Individual
ALEXANDRA DEPORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 948-1478
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 948-1478
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301502122
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
05/28/2015
Last updated
03/02/2021
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