Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 11017249A | IN |
NPI | 1093151607 |
---|---|
Provider Name | Dr. Hadia Marie Leon |
First Address | Indianapolis, IN 46203-1790 |
Second Address | Indianapolis, IN 46202-5135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2013 |
Last Update Date | 09/06/2013 |