Provider Demographics
NPI:1730146119
Name:NEUMAN, LESLIE AARON (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:AARON
Last Name:NEUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 MICHIGAN ST NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1221
Mailing Address - Country:US
Mailing Address - Phone:616-957-4090
Mailing Address - Fax:616-957-4095
Practice Address - Street 1:2855 MICHIGAN ST NE
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1221
Practice Address - Country:US
Practice Address - Phone:616-957-4090
Practice Address - Fax:616-957-4095
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010362072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MILN036207OtherBCBS OF MI STATE LIC
MI1247316Medicaid
MIB43386Medicare UPIN
MIN91950003Medicare ID - Type UnspecifiedMEDICARE GRP INDIVIDUAL