Provider Demographics
NPI:1992921753
Name:STUART LEFF, DPM,P.C.
Entity type:Organization
Organization Name:STUART LEFF, DPM,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:LEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:586-268-6110
Mailing Address - Street 1:2405 E 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5961
Mailing Address - Country:US
Mailing Address - Phone:586-268-6110
Mailing Address - Fax:586-264-1155
Practice Address - Street 1:2405 E 14 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5961
Practice Address - Country:US
Practice Address - Phone:586-268-6110
Practice Address - Fax:586-264-1155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901000543213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0E00222OtherBCBSM
5505253OtherBCBSM
480E002220OtherBCN
0198020001Medicare NSC
5505253OtherBCBSM
480E002220OtherBCN