Individual
LEROY WILSON MCCUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4650 SOUTHWESTERN BLVD., HAMBURG, NY 14075-1465
(716) 648-2450
Mailing address
2875 UNION RD, SUITE 8, CHEEKTOWAGA, NY 14227-1465
(716) 651-0911
(716) 651-9855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
158075
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010113905
UNIVERA
NY
01
—
000510096007
BC/BS
NY
05
—
00903104
—
NY
01
—
0105775
IHA
NY
01
—
040511000242
FIDELIS
NY
01
—
151123BF
PREFERRED CARE
NY
Enumeration date
09/26/2005
Last updated
07/21/2014
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