Individual
MR. LEO F KENZAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1602 SKIPWITH RD, RICHMOND, VA 23229-5205
(804) 289-4500
Mailing address
4050 INNSLAKE DR, SUITE 308, GLEN ALLEN, VA 23060-3327
(804) 521-5315
(804) 521-5312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101233641
VA
208000000X
Pediatrics Physician
0101233641
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10228905
ANTHEM
VA
05
—
10228905
—
VA
05
—
1457342255
—
VA
01
—
302011
ANTHEM
VA
01
—
6230121
CIGNA
VA
01
—
631615
SOUTHERN HEALTH
VA
01
—
P00601102
MEDICARE RAILROAD
VA
01
—
P00606712
RR MEDICARE
VA
Enumeration date
10/31/2005
Last updated
09/23/2009
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