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Individual

TAL O. LEYSHON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8 LAKE MONT DR, SAINT ALBANS, VT 05478-6003
(734) 255-0409
Mailing address
8 LAKE MONT DR, SAINT ALBANS, VT 05478-6003
(734) 255-0409

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101249348
VA
207L00000X
Anesthesiology Physician
Primary
0420012469
VT
390200000X
Student in an Organized Health Care Education/Training Program
2901018572
MI

Other

Enumeration date
04/19/2007
Last updated
06/07/2013
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