Individual
LESLIE M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
765 N HAMILTON RD, STE. 255, GAHANNA, OH 43230-8703
(614) 337-9100
(614) 337-0027
Mailing address
765 N HAMILTON RD, STE. 255, GAHANNA, OH 43230-8703
(614) 337-9100
(614) 337-0027
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.063613
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0883754
—
OH
Enumeration date
02/09/2007
Last updated
07/09/2007
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