Individual
DR. JONATHAN B LEIZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17747 CHILLICOTHE RD, SUITE 100, CHAGRIN FALLS, OH 44023-4739
(440) 543-8855
(440) 543-2470
Mailing address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35075091L
OH
2083X0100X
Occupational Medicine Physician
35075091
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210557
ANTHEM
OH
05
—
2191079
—
OH
Enumeration date
10/20/2005
Last updated
11/02/2011
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