Provider Demographics
NPI:1316945413
Name:HARVEY LEFKOWITZ, D.P.M., P.C.
Entity type:Organization
Organization Name:HARVEY LEFKOWITZ, D.P.M., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LEFKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-548-7363
Mailing Address - Street 1:641 W 9 MILE RD
Mailing Address - Street 2:SUITE '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:SUITE '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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI480F36430OtherBLUE CROSS/BLUE SHIELD
MI480F36430OtherBLUE CROSS/BLUE SHIELD
MI0182160001Medicare NSC