Healthcare Provider Details

I. General information

NPI: 1033613294
Provider Name (Legal Business Name): LEAH MICHELLE KURTH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HENRY FORD WYANDOTTE HOSPITAL, MEDICAL EDUCATION DEPART 2333 BIDDLE AVE
WYANDOTTE MI
48192
US

IV. Provider business mailing address

HENRY FORD WYANDOTTE HOSPITAL, MEDICAL EDUCATION DEPART 2333 BIDDLE AVE
WYANDOTTE MI
48192
US

V. Phone/Fax

Practice location:
  • Phone: 734-246-8004
  • Fax:
Mailing address:
  • Phone: 734-246-8004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101023747
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5151012768
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: