Individual
LEIGHTON MS LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
5101004913
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1915992
—
MI
05
—
1917511
—
MI
01
—
300049507
RRMC
MI
01
—
300F361250
BCBS GROUP #
MI
01
—
310D460020
BCBS GROUP PIN #
MI
01
—
3156301714
BCBS INDIVIDUAL PIN #
MI
01
—
CA3518
MEDICARE RR GROUP PIN
MI
Enumeration date
06/28/2006
Last updated
02/06/2013
Update your record
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