Individual
DR. LONNIE JOE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22255 GREENFIELD RD, STE 280, SOUTHFIELD, MI 48075-3712
(248) 557-5227
(248) 557-1732
Mailing address
22255 GREENFIELD RD, STE 280, SOUTHFIELD, MI 48075-3712
(248) 557-5227
(248) 557-1732
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301041569
MI
207RP1001X
Pulmonary Disease Physician
LJ041569
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106317218
BLUE CROSS BLUE SHIELD
MI
05
—
1490579
—
MI
01
—
382494448
TAX ID
MI
Enumeration date
01/23/2007
Last updated
02/14/2024
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