Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 040449 | GA |
NPI | 1093706426 |
---|---|
Provider Name | Dr. Steven W Leard |
First Address | Atlanta, GA 30308-1609 |
Second Address | Stockbridge, GA 30281-9075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 09/07/2007 |