Individual
DR. WILLIAM T LEEBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 JOHN ST, KALAMAZOO, MI 49007-5341
(269) 341-7654
Mailing address
PO BOX 105, GRAND RAPIDS, MI 49501-0105
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301044498
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1490971
—
MI
01
—
220009771
RAILROAD
—
01
—
220012737
RAILROAD
—
05
—
2933494
—
MI
Enumeration date
11/28/2005
Last updated
07/16/2008
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