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Individual

DR. LEILA GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4201 SAINT ANTOINE ST, 6C UHC/DMC, DETROIT, MI 48201-2153
(313) 577-5013
Mailing address
1300 E LAFAYETTE ST, APT 1905, DETROIT, MI 48207-2905

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BH26634488143
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BH26634488143
EDUCATIONAL LICENSE
MI
Enumeration date
11/13/2008
Last updated
11/13/2008
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