Individual
DR. WALTER CLIFFORD LEIBOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2106 S GRAY RD, WEST BRANCH, MI 48661-9606
(989) 345-7880
(989) 345-7882
Mailing address
2106 S GRAY RD, WEST BRANCH, MI 48661-9606
(989) 345-7880
(989) 345-7882
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
WL041417
MI
208D00000X
General Practice Physician
4301041417
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2125588
—
MI
Enumeration date
10/31/2006
Last updated
06/19/2014
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