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Individual

LEON G MICHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1801 CLIFTY DR, MADISON, IN 47250-1627
(812) 265-6800
(812) 265-1470
Mailing address
1801 CLIFTY DR, MADISON, IN 47250-1627
(812) 265-6800
(812) 265-1470

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01022267
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000042198
ANTHEM BCBS
IN
01
020041435
MEDICARE RAILROAD
05
100047820A
IN
01
1073889
PASSPORT KY MEDICAID
KY
01
2435127000
PASSPORT ADVANTAGE
KY
01
410017P
SIHO
IN
01
4370917
AETNA
05
64349947
KY
Enumeration date
06/21/2006
Last updated
08/22/2012
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