Individual
DR. LORI MARCUM FEDORONKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1350 KIRTS BLVD, SUITE 155, TROY, MI 48084-4851
(248) 362-0222
(248) 362-1165
Mailing address
1350 KIRTS BLVD, SUITE 155, TROY, MI 48084-4851
(248) 362-0222
(248) 362-1165
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301064064
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3415994
—
MI
Enumeration date
10/27/2005
Last updated
09/06/2024
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