Lisa Anne Fulgenzi, MD | |
26711 Woodward Ave Ste 103, Huntington Woods, MI 48070 | |
(248) 543-6000 | |
(248) 543-3770 |
Full Name | Lisa Anne Fulgenzi |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Experience | 35 Years |
Location | 26711 Woodward Ave Ste 103, Huntington Woods, Michigan |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962475236 | NPI | - | NPPES |
443604010 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | LF054789 (Michigan) | Primary |
208000000X | Pediatrics | LF054789 (Michigan) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Ascension Providence Hospital, Southfield And Novi | Southfield, MI | Hospital |
Beaumont Hospital Royal Oak | Royal oak, MI | Hospital |
Entity Name | Berkley Primary Care, Plc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316082399 PECOS PAC ID: 8325052251 Enrollment ID: O20060131000439 |
Mailing Address | Practice Location Address |
---|---|
Lisa Anne Fulgenzi, MD 26711 Woodward Ave Ste 103, Huntington Woods, MI 48070 Ph: (248) 543-6000 | Lisa Anne Fulgenzi, MD 26711 Woodward Ave Ste 103, Huntington Woods, MI 48070 Ph: (248) 543-6000 |
Jack Shartsis, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 12923 Lincoln Dr, Huntington Woods, MI 48070 Phone: 248-591-7940 | |
Karen Marie Swanson, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 26711 Woodward Ave, Ste 103, Huntington Woods, MI 48070 Phone: 248-543-6000 Fax: 248-543-3770 |