Individual
LESLIE A RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-3712
(910) 450-3766
Mailing address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(910) 450-4127
(910) 450-3766
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
95-00703
NC
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
95-00703
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780604751
—
NC
01
—
71547
NCBCBS
NC
05
—
8971547
—
NC
05
—
NC2600
—
SC
Enumeration date
07/20/2006
Last updated
01/08/2025
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