Provider Demographics
NPI:1306258587
Name:FILLER, ALICIA MICHELLE (DO)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:MICHELLE
Last Name:FILLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 W LAKE LANSING RD STE 300
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6337
Mailing Address - Country:US
Mailing Address - Phone:517-253-3910
Mailing Address - Fax:
Practice Address - Street 1:1651 W LAKE LANSING RD STE 300
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6337
Practice Address - Country:US
Practice Address - Phone:517-253-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021112207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology