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Individual

EDI LEVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4646 JOHN R ST, PALMS 11LAB, DETROIT, MI 48201-1916
(313) 576-1000
(313) 576-1120
Mailing address
4646 JOHN R ST, PALMS 11LAB, DETROIT, MI 48201-1916

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301079179
MI

Other

Enumeration date
08/09/2006
Last updated
10/08/2024
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