Basic Information
Provider Information
NPI: 1245758614
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAPUM
FirstName: WARREN
MiddleName:  
NamePrefix: MR.
NameSuffix: II
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber: 3134504500
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/06/2017
LastUpdateDate: 09/06/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X4704176636MIY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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