| Doctor Name: | LEONHARD J MAENDEL |
| NPI Number: | 1629138854 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 5601002674 |
| Business Practice Address: | 223 N Park St Boyne City, MI - 497121220 |
| Business Phone Number: | 2315825314 |
| Business Fax Number: | 2315825338 |
| Mailing Address: | 223 N Park St, BOYNE CITY |
| State: | MI |
| Postal Code: | 497121220 |
| Phone Number: | 2315825314 |
| Fax Number: | 2315825338 |
| NPI Enumeration Date: | 12/11/2006 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601002674 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |