Individual
CHARLES J. LEIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 HIGHLAND AVUENE, SUITE 201, SALEM, MA 01970
(978) 745-6601
(978) 744-4872
Mailing address
12 PHILLIPS BEACH AVENUE, SWAMPSCOTT, MA 01907
(781) 599-1915
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
41165
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012295
NEIGHBORHOOD HEALTH
MA
01
—
041165
TUFTS
MA
01
—
1000022
UNITED HEALTH CARE
MA
01
—
19337
HARVARD PILGRIM
MA
05
—
2054434
—
MA
01
—
2084278
AETNA
MA
01
—
36228
FALLON
MA
01
—
D25068
BLUE SHIELD
MA
Enumeration date
02/10/2006
Last updated
08/01/2008
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