Provider Demographics
NPI:1154314649
Name:SALVIA, LEONARD C (DO)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:C
Last Name:SALVIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6889 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-1658
Mailing Address - Country:US
Mailing Address - Phone:248-666-5200
Mailing Address - Fax:248-666-5069
Practice Address - Street 1:6889 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1658
Practice Address - Country:US
Practice Address - Phone:248-666-5200
Practice Address - Fax:248-666-5069
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315144325207RC0000X
MILC007186207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1893957Medicaid
MIC4344OtherM-CARE
MI103316OtherCARE CHOICES
MI310F337240OtherBCBS CMG
MIE31603OtherHEALTH ALLIANCE PLAN
MI5633892OtherBCBSM
MI0F31072OtherBCBS COMMON PROV ID #
MI4608491Medicaid
MIE31603OtherHEALTH ALLIANCE PLAN
MI5633892OtherBCBSM
MI0P44710Medicare PIN