Individual
DR. LANNY GREEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23077 GREENFIELD RD, 144, SOUTHFIELD, MI 48075-3709
(248) 569-6120
(248) 569-6134
Mailing address
23077 GREENFIELD RD, 144, SOUTHFIELD, MI 48075-3709
(248) 569-6120
(248) 569-6134
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301077362
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4289294
—
MI
Enumeration date
05/22/2006
Last updated
07/09/2007
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