Individual
DR. LEENA MAMMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3186 VILLAGE DR STE 201, FAYETTEVILLE, NC 28304-3979
(910) 486-5700
(910) 486-5950
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7272
(616) 363-7290
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2022-02626
NC
2085R0202X
Diagnostic Radiology Physician
4301081377
MI
Other
Enumeration date
07/12/2006
Last updated
01/10/2023
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