Provider Demographics
NPI:1609443530
Name:LEVENTIS, NICHOLAS G (DO)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:G
Last Name:LEVENTIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2252 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-4254
Mailing Address - Country:US
Mailing Address - Phone:734-682-5434
Mailing Address - Fax:734-244-5184
Practice Address - Street 1:2252 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-4254
Practice Address - Country:US
Practice Address - Phone:734-682-5434
Practice Address - Fax:734-244-5184
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2024-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101028114207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine