Individual
LISA WHITEHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4200 WHITEHALL DR STE 230, ANN ARBOR, MI 48105-9694
(734) 769-3896
(734) 769-3746
Mailing address
24 FRANK LLOYD WRIGHT DR STE J2000, ANN ARBOR, MI 48105-9484
(734) 747-6766
(734) 222-3100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301115085
MI
208000000X
Pediatrics Physician
D0072297
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044096500
—
MD
Enumeration date
05/31/2007
Last updated
06/27/2018
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