Individual
DR. TODD THORNTON LAVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4160 JOHN R ST STE 615, DETROIT, MI 48201-2022
(313) 745-8773
(313) 993-0595
Mailing address
1560 E MAPLE RD, SUITE 400- CREDENTIALING DEPARTMENT, TROY, MI 48083-1138
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301090570
MI
Other
Enumeration date
03/01/2009
Last updated
05/06/2015
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