| Organization Name: | LESLIE MEDICAL CENTER P C |
| NPI Number: | 1316160971 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMUR ANUM BARUTI (PHYSICIAN) |
| Mailing Address: | 207 E Bellevue St Leslie |
| State: | MI US |
| Postal Code: | 492519373 |
| Phone Number: | 5175898252 |
| Fax Number: | 5175895189 |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 03/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | 4301052165 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |