Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | VT |
NPI | 1790706281 |
---|---|
Provider Name | Dr. David Welker Leitner |
First Address | South Hero, VT 05486-4615 |
Second Address | Colchester, VT 05446-5968 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006165 | (05) | VT |
B85546 | (02) | VT |
E00860980 | (05) | NY |