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Individual

LEWIS A LEAVITT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 HIGHLAND AVE, MADISON, WI 53705
(608) 263-5815
(608) 833-6932
Mailing address
8007 EXCELSIOR DRIVE, MADISON, WI 53717
(608) 829-5238
(608) 833-6932

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
17402
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31031500
WI
Enumeration date
03/10/2006
Last updated
07/08/2007
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