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Individual

LESLIE RUMBAUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
BON SECOURS ENDOCRINOLOGY, 2 INNOVATION DRIVE, STE 300B, GRENVILLE, SC 29607-5261
(864) 400-3680
(864) 400-3681
Mailing address
PO BOX 743294, ATLANTA, GA 30374-3294

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2233
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2191PA
SC
Enumeration date
11/05/2014
Last updated
06/07/2018
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