Provider Demographics
NPI:1073644944
Name:LEONARD T. KARADIMAS,DO.,PC
Entity Type:Organization
Organization Name:LEONARD T. KARADIMAS,DO.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARSHEFKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-385-7631
Mailing Address - Street 1:3041 COMMERCE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3820
Mailing Address - Country:US
Mailing Address - Phone:810-385-7400
Mailing Address - Fax:810-385-7812
Practice Address - Street 1:3041 COMMERCE DR
Practice Address - Street 2:SUITE A
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3820
Practice Address - Country:US
Practice Address - Phone:810-385-7400
Practice Address - Fax:810-385-7812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILK012026207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty