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NPI Code Detail

MEDICARE: LESLIE DENISE BAUGH PA

MEDICARE: LESLIE DENISE BAUGH PA
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 Assistant5601002565MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15601002565OTHERMILICENSE

General Provider Information

NPI Number : 1942428297
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE DENISE BAUGH PA
Provider Business Mailing Address
First Line : 18000 W 9 MILE RD STE 200
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-4020
Country : US
Telephone Number : 248-336-4000
Fax Number :
Provider Business Practice Location Address
First Line : 4420 E DAVISON ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-1744
Country : US
Telephone Number : 248-336-4000
Fax Number : 248-581-8839
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 09/17/2025

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Directions to “ LESLIE DENISE BAUGH PA” Practice Location

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