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General NPI Number Information
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NPI Number | 1316160971
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Entity Type | Organization
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Legal Business Name | LESLIE MEDICAL CENTER P C
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 03/22/2010
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Provider Practice Location Address
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Address Line | 207 E BELLEVUE ST
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City | LESLIE
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State | MI
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Zip | 49251-9373
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Country | US
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Telephone | 517-589-8252
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Fax | 517-589-5189
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Provider Business Mailing Address
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Address Line | 207 E BELLEVUE ST
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City | LESLIE
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State | MI
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Zip | 49251-9373
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Country | US
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Telephone | 517-589-8252
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Fax | 517-589-5189
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TIMUR ANUM BARUTI
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Credential | MD
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Telephone | 517-589-8252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 4301052165
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License Number State | MI
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