Healthcare Provider Details

I. General information

NPI: 1447230032
Provider Name (Legal Business Name): MICHAEL JEFFREY LEINWAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 JOHN ST SUITE M351
KALAMAZOO MI
49007-5341
US

IV. Provider business mailing address

601 JOHN ST SUITE M-351
KALAMAZOO MI
49007-5341
US

V. Phone/Fax

Practice location:
  • Phone: 226-934-1690
  • Fax: 269-341-7883
Mailing address:
  • Phone: 269-341-1690
  • Fax: 269-341-7883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number4301086349
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number75727
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME160795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: