Basic Information
| Provider Information | |||||||||
| NPI: | 1619970423 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEUCHTER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26400 W 12 MILE RD | ||||||||
| Address2: | STE 170 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480341753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482088787 | ||||||||
| FaxNumber: | 2482088788 | ||||||||
| Practice Location | |||||||||
| Address1: | 26400 W 12 MILE RD | ||||||||
| Address2: | STE 170 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480341753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482088787 | ||||||||
| FaxNumber: | 2482088788 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MI | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.