Individual
LEAH CAROL BUMGARNER TEMPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-8190
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
200401139
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
200401139
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10131511
—
VA
01
—
1378W
BCBS
—
05
—
3810001522
—
WV
01
—
7986713
AETNA
—
01
—
804976
PARTNERS
—
05
—
891378W
—
NC
01
—
D8021
MEDCOST
—
01
—
P00416720
RR MEDICARE
—
05
—
Q0113C
—
SC
Enumeration date
12/19/2005
Last updated
08/15/2023
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