Individual
DR. JONATHAN LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 E GROVER ST, SHELBY, NC 28150-3917
(980) 487-3131
Mailing address
819 SPRUCE ST, CHARLOTTE, NC 28203-4332
(704) 340-8290
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
127380
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5910332
—
NC
Enumeration date
03/06/2007
Last updated
05/06/2013
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