Provider Demographics
NPI:1861499519
Name:LEFKOWITZ, HARVEY MARK (DPM)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:MARK
Last Name:LEFKOWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 W 9 MILE RD
Mailing Address - Street 2:STE A
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1779
Mailing Address - Country:US
Mailing Address - Phone:248-548-7363
Mailing Address - Fax:248-548-5304
Practice Address - Street 1:641 W 9 MILE RD
Practice Address - Street 2:STE A
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1779
Practice Address - Country:US
Practice Address - Phone:248-548-7363
Practice Address - Fax:248-548-5304
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001039213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1437141Medicaid
MI382469733OtherTAX ID FOR PRIMARY LOCATI
MI485635062OtherBLUE CROSS BLUE SHIELD
T34134Medicare UPIN
MI1437141Medicaid