Individual
DR. LEON RONEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97 GREAT TEAYS BLVD, STE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 757-3252
Mailing address
97 GREAT TEAYS BLVD, STE 6, SCOTT DEPOT, WV 25560-9815
(304) 757-6999
(304) 757-3252
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
19878
WV
207Q00000X
Family Medicine Physician
Primary
19878
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054842-000
—
WV
01
—
110190764
RAILROAD MEDICARE
—
Enumeration date
04/18/2006
Last updated
10/16/2019
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