Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 61822 | MN |
N | 207VG0400X | Gynecologist | 5706 | AK |
NPI | 1568456622 |
---|---|
Provider Name | Dr. Douglas Allan Leach |
First Address | Portsmouth, VA 23708 |
Second Address | Portsmouth, VA 23708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 14/09/2021 |