Individual
DR. LAWRENCE JORDAN BREYFOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, UH B1D530, SPC 5030, ANN ARBOR, MI 48109-5030
(734) 615-4924
Mailing address
1500 E MEDICAL CENTER DRIVE, UH B1D530, SPC 5030, ANN ARBOR, MI 48109-5030
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4351046184
MI
Other
Enumeration date
05/12/2020
Last updated
05/14/2020
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