Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 0101030909 | VA |
NPI | 1053405787 |
---|---|
Provider Name | David W Leffke |
First Address | Lynchburg, VA 24501-1602 |
Second Address | Lynchburg, VA 24501-1602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 03/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7581815 | (05) | VA |
B05213 | (02) | VA |