Individual
DR. MARK T LEAHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 E 29TH ST, FREMONT, NE 68025-2384
(402) 721-3133
(402) 941-7017
Mailing address
700 E 29TH ST, FREMONT, NE 68025-2384
(402) 721-3133
(402) 941-7017
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
19033
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47053664516
—
NE
Enumeration date
02/22/2006
Last updated
11/01/2011
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