Individual
MR. RANDY NEIL MARVIN LEVESQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTTIONER
Contact information
Practice address
1700 BIDDLE AVE, WYANDOTTE, MI 48192-7205
(734) 284-2026
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704227414
MI
Other
Enumeration date
07/03/2017
Last updated
06/16/2022
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