Provider Demographics
NPI:1043427768
Name:MICHAEL E. LEIBOWITZ, M.D.,P.C.
Entity Type:Organization
Organization Name:MICHAEL E. LEIBOWITZ, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEIBOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-593-6844
Mailing Address - Street 1:11120 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2633
Mailing Address - Country:US
Mailing Address - Phone:301-593-6844
Mailing Address - Fax:301-593-3832
Practice Address - Street 1:11120 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2633
Practice Address - Country:US
Practice Address - Phone:301-593-6844
Practice Address - Fax:301-593-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62142Medicare UPIN
MDH89381Medicare UPIN
MD163606Medicare ID - Type UnspecifiedDR. MICHAEL E. LEIBOWITZ