Individual
ERIC L LEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5200
(269) 387-3290
(269) 387-2944
Mailing address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5200
(269) 387-3290
(269) 387-2944
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301075289
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0803913831
BLUE CROSS INDIVIDUAL
—
05
—
4625261
—
MI
01
—
700C947350
BLUE CROSS GROUP
—
01
—
C30861
RAILROAD MEDICARE
MI
Enumeration date
11/15/2005
Last updated
12/09/2008
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