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Individual
MR. RYAN J LEONBERG
Active
Individual
MR. RYAN J LEONBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4807
MA
363A00000X
Physician Assistant
Primary
—
PA
363AS0400X
Surgical Physician Assistant
MA054338
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031437610001
—
PA
Enumeration date
04/14/2010
Last updated
04/19/2018
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