Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 0101239570 | VA |
NPI | 1194787945 |
---|---|
Provider Name | Dr. Elihu Jose Ledesma |
First Address | Salem, VA 24153-6858 |
Second Address | Salem, VA 24153-6404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 08/07/2007 |