Individual
FREDERIC STUART LEEDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3033 KETTERING BLVD STE 100, MORAINE, OH 45439-1948
(937) 293-2133
Mailing address
PO BOX 40412, BELFAST, ME 04915-1255
(330) 896-5651
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35075225
OH
207QA0505X
Adult Medicine Physician
35075225
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2097449
—
OH
Enumeration date
03/17/2006
Last updated
12/31/2025
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