Provider Demographics
NPI:1841835303
Name:LEFEBVRE, GERARD M JR (PA-C)
Entity type:Individual
Prefix:
First Name:GERARD
Middle Name:M
Last Name:LEFEBVRE
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5333 MCAULEY DR RM 5112
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1003
Mailing Address - Country:US
Mailing Address - Phone:734-712-0478
Mailing Address - Fax:734-712-2099
Practice Address - Street 1:5301 MCAULEY DR STE 5112
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-712-0478
Practice Address - Fax:734-712-2099
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601009499363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical