Provider Demographics
NPI:1386389070
Name:LUPRO, TONI HEAVEN CHANCE (MD)
Entity type:Individual
Prefix:DR
First Name:TONI
Middle Name:HEAVEN CHANCE
Last Name:LUPRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2672 PACKARD ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6831
Mailing Address - Country:US
Mailing Address - Phone:734-626-6005
Mailing Address - Fax:
Practice Address - Street 1:3901 CHRYSLER SERVICE DRIVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-993-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program