Provider Demographics
NPI:1669563821
Name:RAGHAD LEPLEY MD PC
Entity type:Organization
Organization Name:RAGHAD LEPLEY MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAGHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-887-3900
Mailing Address - Street 1:147 N MILFORD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4535
Mailing Address - Country:US
Mailing Address - Phone:248-887-3900
Mailing Address - Fax:248-887-3988
Practice Address - Street 1:147 N MILFORD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4535
Practice Address - Country:US
Practice Address - Phone:248-887-3900
Practice Address - Fax:248-887-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104843725Medicaid
I43830Medicare UPIN
MI0P27010Medicare PIN