Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 2013-01350 | NC |
N | 207R00000X | Internist | 2013-01350 | NC |
N | 111NI0900X | Internist | 2013-01350 | NC |
Y | 207RC0200X | Critical Care Medicine | 2013-01350 | NC |
NPI | 1003102146 |
---|---|
Provider Name | Leonard Alexander Stallings |
First Address | Winston Salem, NC 27157-0001 |
Second Address | High Point, NC 27262-4331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 13/08/2021 |