Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 4301030711 | MI |
NPI | 1023088929 |
---|---|
Provider Name | Dr. James Barry Lesser |
First Address | Novi, MI 48377-2644 |
Second Address | Novi, MI 48377-2644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 17/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4476063-10 | (05) | MI |
D92497 | (02) |