Provider Demographics
NPI:1700233152
Name:LEBLANC, ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:320 N MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-1127
Mailing Address - Country:US
Mailing Address - Phone:248-981-5975
Mailing Address - Fax:734-436-4878
Practice Address - Street 1:320 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1127
Practice Address - Country:US
Practice Address - Phone:248-981-5975
Practice Address - Fax:734-436-4878
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43011096602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry