Leila Ettefagh, M.D.
Pain Medicine, Interventional Pain Medicine in Novi, MI. Individual provider (NPI-1).
NPI number1861887911
StatusActive
Last updated in NPPESJun 13, 2022
Details
- NPI
- 1861887911
- Entity type
- Individual (NPI-1)
- Name
- Leila Ettefagh
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2015
- Certification date
- Jun 13, 2022
- Last updated
- Jun 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0014X | Pain Medicine, Interventional Pain Medicine | 4301117341 | MI | Yes |
| 208100000X | Physical Medicine & Rehabilitation | 4301117341 | MI | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
26750 Providence Pkwy Ste 200Novi, MI 48374-1212
Phone 866-974-2673 · Fax 866-939-2673
Mailing address
26750 Providence Pkwy Ste 200Novi, MI 48374-1212
Phone 866-974-2673 · Fax 866-939-2673
Other practice locations
261 Mack Ave Ste 188
Detroit, MI 48201-2417
Detroit, MI 48201-2417
Phone 313-745-4600 · Fax 313-966-8294
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