Organization
KELLAM & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGHTON LUM D.O. (PARTNER)
(734) 677-7400
Entity
Organization
Contact information
Practice address
399 S BROADWAY ST, LAKE ORION, MI 48362-2740
(248) 338-5604
(248) 338-5605
Mailing address
4420 VARSITY DR, ANN ARBOR, MI 48108-2233
(734) 677-7400
(734) 677-7407
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
07/15/2008
Last updated
12/14/2009
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