Individual
MARY LULGJURAJ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
44201 DEQUINDRE, 400 FSC - PCS, TROY, MI 48085-1198
(248) 423-3144
Mailing address
130 TOWN CENTER DR, STE 203, TROY, MI 48084-1744
(248) 585-8221
(248) 585-8270
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704221264
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430F364420
BCBSM
MI
05
—
4684600
—
MI
Enumeration date
03/10/2006
Last updated
09/27/2017
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