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Individual

CHARLES T LEEWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5356 REYNOLDS ST, 201, SAVANNAH, GA 31405-6016
(912) 819-8187
(912) 232-9701
Mailing address
5501 ABERCORN ST, C172, SAVANNAH, GA 31405-6911
(912) 232-9700
(912) 232-9701

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-115155
IL
207P00000X
Emergency Medicine Physician
Primary
061117
GA
207P00000X
Emergency Medicine Physician
1186
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
440010727A
GA
05
440010727B
GA
05
440010727C
GA
05
G61117
GA
Enumeration date
05/24/2006
Last updated
01/07/2015
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