Matthew James Leach, R.PH.
Individual provider Active NPI Pharmacist · Dundee, MI
NPI 1023104841 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023104841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302032420 (MI)
- Practice address
- 100 Powell Dr.
Suite 1
Dundee, MI 48131 - Phone
- (734) 240-3333
- Fax
- (734) 240-3334
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302032420 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302032420 | MI | Yes |
Addresses
Primary practice location
100 Powell Dr.
Suite 1
Dundee, MI 48131
Mailing address
2119 W Hurd Rd
Monroe, MI 48162-9490
Phone (734) 625-5111
Other providers in Dundee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.