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Individual
BRENDAN LEROY
Active
Individual
BRENDAN LEROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01062433
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000566825
INDIANA BCBS/ANTHEM HEALTH
—
05
—
200830820
—
IN
01
—
9814091
AETNA HEALTH PLANS
—
01
—
P01390900
MEDICARE RR PTAN
IN
Enumeration date
10/24/2006
Last updated
11/27/2023
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