Individual
DR. LEON PEDELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 618-6260
(284) 618-6260
Mailing address
PO BOX 8225, BLOOMFIELD HILLS, MI 48302-8225
(248) 618-6260
(284) 618-6260
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
LP036862
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106348892
BLUE CROSS BLUE SHIELD MI
MI
05
—
2097821
—
MI
Enumeration date
06/05/2006
Last updated
07/08/2007
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