| Organization Name: | RONALD S LEDERMAN, MD, PLLC |
| NPI Number: | 1003964610 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD S LEDERMAN (MEDICAL DIRECTOR) |
| Mailing Address: | 2300 Haggerty Rd Suite 1110 West Bloomfield |
| State: | MI US |
| Postal Code: | 483232184 |
| Phone Number: | 2486692000 |
| Fax Number: | 2486692110 |
| NPI Enumeration Date: | 01/08/2007 |
| NPI Last Update Date: | 10/31/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 064514 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |