Individual
ROBERT S LEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 VILLAGE CENTER BLVD, SUITE 200, MYRTLE BEACH, SC 29579-6683
(843) 236-3222
(843) 236-3005
Mailing address
210 VILLAGE CENTER BLVD, SUITE 200, MYRTLE BEACH, SC 29579-6683
(843) 236-3222
(843) 236-3005
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
23258
SC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
23258
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8906243
—
NC
05
—
T74602
—
SC
Enumeration date
04/22/2006
Last updated
08/25/2014
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