Individual
DR. MICHAEL LENNEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1431 NURSERY ST STE 102, FOGELSVILLE, PA 18051-1612
(610) 821-4920
Mailing address
4076 NEELY ROAD, FORT WAINWRIGHT, AK 99703
(907) 361-4835
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
31247
NE
208000000X
Pediatrics Physician
Primary
MD483842
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/04/2017
Last updated
07/08/2024
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