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Individual

STEFAN W LEICHTLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8260 WILLOW OAKS CORPORATE DR STE 600, FAIRFAX, VA 22031-4528
(571) 472-4670
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101259042
VA
2086S0102X
Surgical Critical Care Physician
Primary
0101259042
VA
2086S0127X
Trauma Surgery Physician
0101259042
VA

Other

Enumeration date
04/01/2009
Last updated
03/21/2024
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