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Individual

DR. RANDALL MARK LEJA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
100 MICHIGAN ST NE # 13, GRAND RAPIDS, MI 49503-2560
(616) 267-0073
Mailing address
538 BOND AVE NW APT 402, GRAND RAPIDS, MI 49503-6705
(517) 740-7279

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101019817
MI

Other

Enumeration date
06/18/2012
Last updated
06/18/2012
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