Individual
DR. LYDIA JOY DONOGHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3901 BEAUBIEN ST, DEPT OF PEDIATRIC SURGERY, DETROIT, MI 48201-2119
(313) 831-3220
(313) 745-0747
Mailing address
8234 JOHN R, DETROIT, MI 48202-2506
(248) 219-5620
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
35095454
OH
2086S0120X
Pediatric Surgery Physician
Primary
4301077977
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000674254
ANTHEM
OH
01
—
07021
PARAMOUNT
OH
05
—
3044351
—
OH
01
—
9244570
AETNA
OH
Enumeration date
12/15/2008
Last updated
10/23/2024
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