Individual
DR. NICHOLE KATHLEEN LAVANWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, B1-380 TC, ANN ARBOR, MI 48109-0999
(734) 763-7919
(734) 763-9298
Mailing address
5690 HAMPSHIRE LN, YPSILANTI, MI 48197-3203
(708) 369-2423
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01082995A
IN
207P00000X
Emergency Medicine Physician
Primary
036125024
IL
Other
Enumeration date
03/26/2007
Last updated
02/17/2022
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