Individual
DR. EDWARD SAMUEL LEIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 COLCHESTER AVE, EAST PAVILION LEVEL 5, RHEUMATOLOGY, BURLINGTON, VT 05401-1473
(802) 847-4574
Mailing address
1 REPA DR, ESSEX JCT, VT 05452-3361
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
042-0006150
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007995
—
VT
Enumeration date
08/18/2006
Last updated
07/08/2007
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