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Individual

DR. LEONARD P LACIVITA

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
39525 W 14 MILE RD, STE 101, NOVI, MI 48377-1632
(248) 926-6673
(248) 926-6683
Mailing address
39525 W 14 MILE RD, STE 101, NOVI, MI 48377-1632
(248) 926-6673
(248) 926-6683

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301406820
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3279382
MI
Enumeration date
11/16/2005
Last updated
07/08/2007
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