Individual
MR. LEONARD R PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
520 UPPER CHESAPEAKE DR, SUITE 206, BEL AIR, MD 21014-4339
(410) 879-9100
(410) 879-0227
Mailing address
520 UPPER CHESAPEAKE DR, SUITE 206, BEL AIR, MD 21014-4339
(410) 879-9100
(410) 879-0227
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D0020022
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2238291
AETNA HMO
MD
01
—
34735011
BLUE SHIELD OF MD
MD
01
—
4669138
AETNA PPO
MD
01
—
498841
NCAS
MD
05
—
82012000
—
MD
01
—
E5130006
BLUECHOICE
DC
Enumeration date
12/29/2006
Last updated
07/08/2007
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