LUCAS TIDWELL

SOUTHFIELD, MI
NPI1942837588
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: MI  4301514131)
Enumeration Date2020-03-24
Last Update Date2025-07-08
Business Address
LUCAS TIDWELL MD
22250 PROVIDENCE DR STE 206
SOUTHFIELD, MI 48075-6210
Phone number: 248-662-4333
Mailing Address
LUCAS TIDWELL MD
22250 PROVIDENCE DR STE 206
SOUTHFIELD, MI 48075-6210
Phone number: 248-662-4333
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