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General NPI Number Information
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NPI Number | 1457450777
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Entity Type | Individual
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Provider Name | DAVID M LEAVITT MD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 107 APRILL DR SUITE 4
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City | ANN ARBOR
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State | MI
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Zip | 48103-1956
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Country | US
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Telephone | 734-903-0350
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Fax | 734-903-0350
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Provider Business Mailing Address
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Address Line | 4525 N RAVENSWOOD AVE STE 201
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City | CHICAGO
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State | IL
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Zip | 60640-5201
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Country | US
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Telephone | 734-913-0350
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Fax | 734-913-0350
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 45475
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M-15188
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD29549
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301095624
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License Number State | MI
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