Individual
ELIZABETH LANE MCCULLOUGH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16836 NEWBURGH RD, UPC LIVONIA, LIVONIA, MI 48154
(888) 362-7792
Mailing address
3800 WOODWARD AVE, SUITE 702, DETROIT, MI 48201-2061
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4101071482
MI
Other
Enumeration date
05/30/2006
Last updated
07/08/2007
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