Individual
LAURIE DIANE DONALDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, LOBBY A, ANN ARBOR, MI 48105-9484
(734) 930-7400
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301086674
MI
2080S0010X
Pediatric Sports Medicine Physician
Primary
4301086674
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4828620
—
MI
Enumeration date
09/25/2006
Last updated
10/22/2020
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