Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0116029544 | VA |
NPI | 1063862035 |
---|---|
Provider Name | Wesley Maurice Leong |
First Address | Roanoke, VA 24011-1924 |
Second Address | Roanoke, VA 24014-1838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2016 |
Last Update Date | 20/06/2016 |