Individual
LEONIDES DIZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2463 S M 30, WEST BRANCH, MI 48661-9312
(989) 345-3660
Mailing address
75 REMIT DRIVE, LOCKBOX 6895, CHICAGO, IL 60675-6895
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301032990
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4214542
—
MI
Enumeration date
07/13/2006
Last updated
02/08/2008
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