Provider Demographics
NPI:1558411256
Name:ARONOVITZ, LEONARD EDWARD (DO)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:EDWARD
Last Name:ARONOVITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1401 ARDMOOR DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-2163
Mailing Address - Country:US
Mailing Address - Phone:248-646-9438
Mailing Address - Fax:
Practice Address - Street 1:26400 W 12 MILE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1700
Practice Address - Country:US
Practice Address - Phone:248-353-1117
Practice Address - Fax:248-353-0726
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101005893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE26272Medicare UPIN