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NPI Code Detail

MEDICARE: DR. LEONARD T KARADIMAS DO

MEDICARE: DR. LEONARD T KARADIMAS DO
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
1207X00000XOrthopaedic Surgery PhysicianLK012026MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194797654
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONARD T KARADIMAS DO
Provider Business Mailing Address
First Line : 1231 PINE GROVE AVE
Second Line : SUITE 1A
City : PORT HURON
State : MI
Zip : 48060-3500
Country : US
Telephone Number : 810-985-4300
Fax Number : 810-985-9320
Provider Business Practice Location Address
First Line : 1231 PINE GROVE AVE
Second Line : SUITE 1A
City : PORT HURON
State : MI
Zip : 48060-3500
Country : US
Telephone Number : 810-985-4300
Fax Number : 810-985-9320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 03/23/2012

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