Basic Information
| Provider Information | |||||||||
| NPI: | 1386638138 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAFAVE | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 LONG RAPIDS RD | ||||||||
| Address2: | |||||||||
| City: | ALPENA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497071315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9893542142 | ||||||||
| FaxNumber: | 9893548600 | ||||||||
| Practice Location | |||||||||
| Address1: | 11745 US HIGHWAY 23 S | ||||||||
| Address2: | |||||||||
| City: | OSSINEKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 497669582 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894712156 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 03/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ML056965 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.