Individual
LYDIA ANN LANNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 ARNET ST, YPSILANTI, MI 48198-5753
(734) 539-5080
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301506595
MI
208000000X
Pediatrics Physician
4351045063
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4351045063
LIMITED EDUCATION LICENSE
MI
01
—
5315207167
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
05/29/2019
Last updated
12/14/2022
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