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Individual

LAWRENCE GENE LEICHTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1405 E KILN CREEK PARKWAY, NEWPORT NEWS, VA 23602-9700
(757) 425-1969
(757) 425-1822
Mailing address
PO BOX 4548, VIRGINIA BEACH, VA 23454-0548
(757) 425-1969
(957) 425-1822

Taxonomy

Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
0101042384
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6027571
VA
01
890548P
MEDICAID
NC
Enumeration date
08/10/2006
Last updated
07/08/2007
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