Healthcare Provider Details

I. General information

NPI: 1609095256
Provider Name (Legal Business Name): DAVID LESZKOWITZ DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9178 HIGHLAND RD SUITE 1
WHITE LAKE MI
48386-4619
US

IV. Provider business mailing address

9178 HIGHLAND RD SUITE 1
WHITE LAKE MI
48386-4619
US

V. Phone/Fax

Practice location:
  • Phone: 248-698-1999
  • Fax: 248-698-4446
Mailing address:
  • Phone: 248-698-1999
  • Fax: 248-698-4446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: DAVID LESZKOWITZ
Title or Position: PRESIDENT
Credential: DO
Phone: 248-698-1999