Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301117551 | MI |
N | 111NI0900X | Internist | 4301117551 | MI |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 4301117551 | MI |
N | 207RC0000X | Internist - Cardiovascular Disease | 4301117551 | MI |
NPI | 1568720308 |
---|---|
Provider Name | Dr. Taylor Alexander Lebeis |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Northville, MI 48168-9493 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2012 |
Last Update Date | 11/11/2020 |