Provider Demographics
NPI:1306832332
Name:LEFKOWITZ, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:LEFKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 E MOUNTAIN VIEW RD
Mailing Address - Street 2:SUITE 137
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5199
Mailing Address - Country:US
Mailing Address - Phone:480-614-8555
Mailing Address - Fax:480-614-8666
Practice Address - Street 1:9201 E MOUNTAIN VIEW RD
Practice Address - Street 2:SUITE 137
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5199
Practice Address - Country:US
Practice Address - Phone:480-614-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00537862085R0202X
AZ410372085R0202X
CAG880872085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKC46SHOtherCAREFIRST BCBS
AZ373106Medicaid
DC0025OtherCAREFIRST BCBS
MD005100400Medicaid
MD865L205EMedicare PIN
AZZ133450Medicare PIN
MDKC46SHOtherCAREFIRST BCBS
DC0025OtherCAREFIRST BCBS
AZ373106Medicaid
AZZ125757Medicare PIN