Individual
SCOTT LEFAIVRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 CARRIAGE CIRCLE DR, PONTIAC, MI 48342-3313
(248) 247-4045
Mailing address
140 CARRIAGE CIRCLE DR, PONTIAC, MI 48342-3313
(248) 247-4045
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
L116760603072
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116760603072
—
MI
Enumeration date
08/12/2015
Last updated
08/12/2015
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