Dr Todd Thornton Lavery, MD | |
4160 John R St Ste 615, Detroit, MI 48201-2022 | |
(313) 745-8773 | |
(313) 993-0595 |
Full Name | Dr Todd Thornton Lavery |
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Gender | Male |
Speciality | Surgery |
Location | 4160 John R St Ste 615, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497995641 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 4301090570 (Michigan) | Primary |
Entity Name | University Physician Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447299797 PECOS PAC ID: 8628087681 Enrollment ID: O20060419000518 |
Mailing Address | Practice Location Address |
---|---|
Dr Todd Thornton Lavery, MD 1560 E Maple Rd, Suite 400- Credentialing Department, Troy, MI 48083-1138 Ph: (248) 581-5974 | Dr Todd Thornton Lavery, MD 4160 John R St Ste 615, Detroit, MI 48201-2022 Ph: (313) 745-8773 |
Kaitlyn Dobesh, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Dr. Bellal Ali Joseph, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3056 Fax: 313-916-9920 | |
Charles Edward Lucas, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4160 John R St, Suite 615, Detroit, MI 48201 Phone: 313-745-4195 Fax: 313-993-8669 | |
Christopher Paul Cassell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 313-343-4000 | |
Mitchell Ross Weaver, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3156 Fax: 313-916-3023 | |
Alexander Marinica, Surgery Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr Ste 121, Detroit, MI 48235 Phone: 313-966-3222 | |
Dr. Rachel Wobig, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-5071 Fax: 313-916-9920 |