Individual
BLAKE LEIBOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14995 SHADY GROVE RD, ROCKVILLE, MD 20850-8726
(301) 942-7600
(301) 217-9241
Mailing address
2730 UNIVERSITY BLVD W STE 310, WHEATON, MD 20902-1990
(301) 942-7600
(301) 942-3521
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/23/2016
Last updated
03/25/2022
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