Individual
DR. DAVID BLACK LEESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
517 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-4262
(252) 744-3452
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
035611
DC
208600000X
Surgery Physician
Primary
2017-01194
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568486397
—
NC
01
—
NCX674A
BCBS OF NC
NC
Enumeration date
07/26/2006
Last updated
05/17/2022
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