Provider Demographics
NPI:1609095256
Name:DAVID LESZKOWITZ DO PC
Entity Type:Organization
Organization Name:DAVID LESZKOWITZ DO PC
Other - Org Name:WHITE LAKE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LESZKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-698-1999
Mailing Address - Street 1:9178 HIGHLAND RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-4619
Mailing Address - Country:US
Mailing Address - Phone:248-698-1999
Mailing Address - Fax:248-698-4446
Practice Address - Street 1:9178 HIGHLAND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-4619
Practice Address - Country:US
Practice Address - Phone:248-698-1999
Practice Address - Fax:248-698-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207Q00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F37023OtherBCBSM
MI0F37023OtherBCBSM