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Individual

DR. MARK MICHAEL LEYNGOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3015 E GOLDSTONE DR # 130, MERIDIAN, ID 83642-1549
(208) 900-4673
(208) 266-5033
Mailing address
3015 E GOLDSTONE DR # 130, MERIDIAN, ID 83642-1549
(208) 900-4673
(208) 266-5033

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME116419
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008971400
FL
01
20024303
MEDICARE
ID
Enumeration date
03/16/2007
Last updated
11/10/2022
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