Individual
DR. JENNIFER AMBER LEAGUE-SOBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
165 LOWES FOODS DR, LEWISVILLE, NC 27023-8258
(336) 893-2270
(336) 893-2279
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9800947
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0108388
UNITED HEALTHCARE
—
01
—
080161888
MEDICARE RAILROAD
—
01
—
126PA
BCBS
—
01
—
21272
CIGNA
—
01
—
40709
PARTNERS
—
01
—
7719318
AETNA
—
05
—
89126PA
—
NC
01
—
98071
MEDCOST
—
Enumeration date
08/31/2006
Last updated
03/29/2023
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