Provider Demographics
NPI:1316944275
Name:SAHN, LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:SAHN
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 1:25330 TELEGRAPH RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-7454
Mailing Address - Country:US
Mailing Address - Phone:248-355-1300
Mailing Address - Fax:248-355-1302
Practice Address - Street 1:25330 TELEGRAPH RD
Practice Address - Street 2:SUITE 340
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7454
Practice Address - Country:US
Practice Address - Phone:248-355-1300
Practice Address - Fax:248-355-1302
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010322412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1090020 10Medicaid
MIA76572Medicare UPIN