Individual
PETER LEAFBLAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
11818
MN
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
12/30/2014
Last updated
10/16/2018
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