Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | R74011 | AZ |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | R74011 | AZ |
NPI | 1356787626 |
---|---|
Provider Name | Dr. Michael Phillip Leovic |
First Address | Phoenix, AZ 85006-2612 |
Second Address | Phoenix, AZ 85006-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2013 |
Last Update Date | 20/07/2020 |