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Individual

KENJI LAWRENCE LEONARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
503 BOWMAN GRAY DR, GREENVILLE, NC 27834-7286
(252) 816-0600
(252) 816-0721
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2017-02333
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134415359
NC
01
19XAX
BCBS OF NC
01
NN25310322
MEDICARE
NC
Enumeration date
06/27/2011
Last updated
08/13/2025
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