Individual
LEONHARD J MAENDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
223 N PARK ST, BOYNE CITY, MI 49712-1220
(231) 582-5314
(231) 582-5338
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2386
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002674
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M32390011
MEDICARE PTAN
MI
Enumeration date
12/11/2006
Last updated
02/14/2025
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