Provider Demographics
NPI:1417187014
Name:CECIL, LEAH MICHELLE JENKINS (DO)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MICHELLE JENKINS
Last Name:CECIL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64321 VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48095-2578
Mailing Address - Country:US
Mailing Address - Phone:586-281-6000
Mailing Address - Fax:586-281-6001
Practice Address - Street 1:64321 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48095-2578
Practice Address - Country:US
Practice Address - Phone:586-281-6000
Practice Address - Fax:586-281-6001
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine