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Contact Information

LEILA ETTEFAGH, MD
26750 PROVIDENCE PKWY STE 200
NOVI, MI48374-1212
 Phone: 866-974-2673
 Fax: 866-939-2673
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for LEILA ETTEFAGH · (Female)

NPI Number 1861887911
Status Active
Credentials MD
Entity Individual
Enumeration date 04/04/2015
Last updated 06/13/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301117341
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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