Individual
DIANE MARIE WILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
401 W GREENLAWN AVE, LANSING, MI 48910-2819
(517) 975-9500
(517) 975-9511
Mailing address
804 SERVICE RD, A201, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003309
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821022195
—
MI
Enumeration date
07/10/2006
Last updated
06/08/2016
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