Provider Demographics
NPI:1982731634
Name:MARCOTTE, LEAH MICHELLE (PA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MICHELLE
Last Name:MARCOTTE
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:29600 S WIXOM RD
Mailing Address - Street 2:
Mailing Address - City:WIXOM
Mailing Address - State:MI
Mailing Address - Zip Code:48393-3430
Mailing Address - Country:US
Mailing Address - Phone:248-926-8459
Mailing Address - Fax:248-926-1310
Practice Address - Street 1:4929 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48125-2027
Practice Address - Country:US
Practice Address - Phone:313-292-4820
Practice Address - Fax:313-292-4976
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2022-07-29
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Provider Licenses
StateLicense IDTaxonomies
MI5601004861363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant