Individual
LESLIE GEORGE GONDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3541 W BRADDOCK RD, SUITE 101, ALEXANDRIA, VA 22302-1915
(703) 379-6020
(703) 820-8799
Mailing address
3541 W BRADDOCK RD, SUITE 101, ALEXANDRIA, VA 22302-1915
(703) 379-6020
(703) 820-8799
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101223709
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101223709
M.D. LICENSE
—
Enumeration date
08/23/2006
Last updated
03/07/2023
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