Healthcare Provider Details

I. General information

NPI: 1578544870
Provider Name (Legal Business Name): JEFFREY G LEFLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N HURON RIVER DR STE 200
YPSILANTI MI
48197
US

IV. Provider business mailing address

4350 JACKSON RD STE 260
ANN ARBOR MI
48103-1889
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-3007
  • Fax: 734-434-6317
Mailing address:
  • Phone: 734-434-3007
  • Fax: 734-434-6317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number4301057172
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: