Provider Demographics
NPI:1639140536
Name:JAMES B. LESSER, MD PLLC
Entity Type:Organization
Organization Name:JAMES B. LESSER, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:LESSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-266-2780
Mailing Address - Street 1:44000 W. 12 MILE ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377
Mailing Address - Country:US
Mailing Address - Phone:248-347-8290
Mailing Address - Fax:248-305-6845
Practice Address - Street 1:44000 W 12 MILE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377
Practice Address - Country:US
Practice Address - Phone:248-347-8290
Practice Address - Fax:248-605-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P38170Medicare PIN