Individual
JOHN R LEYENDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L0377
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10080754
—
VA
01
—
1361K
BCBS
NC
05
—
3810000631
—
WV
01
—
7801123
AETNA
—
01
—
804390
PARTNERS
NC
05
—
891361K
—
NC
01
—
D5072
MEDCOST
NC
05
—
Q0054J
—
SC
Enumeration date
12/05/2005
Last updated
01/27/2015
Update your record
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