Individual
EDWIN LOCKWOOD LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2257 HUBER ROAD, FORT MEADE, MD 20755-5378
(443) 845-6295
(301) 677-7149
Mailing address
2043 RIVER DOWNS CT, FOREST HILL, MD 21050-3142
(443) 845-6295
(301) 677-7149
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0001832
MD
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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