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NPI Code Detail

MEDICARE: LEAH CATHERINE TRYBUS PA-C

MEDICARE:   LEAH CATHERINE TRYBUS  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant5601010599MI

General Provider Information

NPI Number : 1114352390
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH CATHERINE TRYBUS PA-C
Provider Business Mailing Address
First Line : 22541 DOVER HILL CT
Second Line :
City : FARMINGTON HILLS
State : MI
Zip : 48335-3911
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7107 N WAYNE RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-2172
Country : US
Telephone Number : 734-578-0009
Fax Number : 734-578-0005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2013
Last Update Date : 04/22/2022

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Directions to “ LEAH CATHERINE TRYBUS PA-C” Practice Location

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