Individual
DR. LACEY WALKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28111 HOOVER RD, 1A, WARREN, MI 48093-4153
(586) 751-8840
Mailing address
28111 HOOVER RD, 1A, WARREN, MI 48093-4153
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301032002
MI
208600000X
Surgery Physician
ME18642
FL
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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