MEDICARE: MRS. LEAH PERRY MD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	374U00000X	Home Health Aide
3	171W00000X	Contractor

Other Identifiers

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

General Provider Information

NPI Number	:	1831839489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEAH PERRY MD

Provider Business Mailing Address
First Line	:	19320 DRESDEN
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2132
Country	:	US
Telephone Number	:	248-866-7192
Fax Number	:

Provider Business Practice Location Address
First Line	:	19320 DRESDEN
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2132
Country	:	US
Telephone Number	:	278-866-7192
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2022
Last Update Date	:	10/05/2023

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