Provider Demographics
NPI:1982872487
Name:MELVIN A LESTER, M.D., P.C.
Entity Type:Organization
Organization Name:MELVIN A LESTER, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-353-0882
Mailing Address - Street 1:27177 LAHSER RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-4714
Mailing Address - Country:US
Mailing Address - Phone:248-353-0882
Mailing Address - Fax:248-353-0883
Practice Address - Street 1:27177 LAHSER RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-4714
Practice Address - Country:US
Practice Address - Phone:248-353-0882
Practice Address - Fax:248-353-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIML024821207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M84760Medicare PIN