Individual
MARIXIE Q LEONOR-GILRANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
239 VILLAGE CENTER PKWY, SUITE 110, STOCKBRIDGE, GA 30281-9024
(770) 506-0095
(770) 506-8060
Mailing address
239 VILLAGE CENTER PKWY, SUITE 110, STOCKBRIDGE, GA 30281-9024
(770) 506-0095
(770) 506-8060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
023757
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000576122D
—
GA
01
—
0971235
AETNA
—
01
—
10033072
AMERIGROUP
GA
01
—
52480810
BCBS
—
01
—
582262190
CIGNA
—
01
—
6051
PEACH STATE
GA
Enumeration date
05/30/2006
Last updated
09/06/2011
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