Individual
DR. DAVID SCOTT LEIDICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
14 CONSULTANT PL 250, DURHAM, NC 27707-6320
(919) 403-1008
(919) 403-2917
Mailing address
PO BOX 52720, DURHAM, NC 27717-2720
(919) 403-1008
(919) 403-2917
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2418
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2451176A
MEDICARE PTAN
NC
05
—
890824L
—
NC
Enumeration date
08/31/2006
Last updated
11/09/2015
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