Individual
LILY GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7330 N CANTON CENTER RD STE 209, CANTON, MI 48187-1538
(734) 454-8001
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301090648
MI
Other
Enumeration date
07/23/2007
Last updated
11/18/2022
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