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Individual

MR. DAVID CAMPBELL LEAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2200 WHITNEY AVE, SUITE 170, HAMDEN, CT 06518-3691
(203) 752-3100
(203) 752-9291
Mailing address
2408 WHITNEY AVE, HAMDEN, CT 06518-3209
(203) 752-3100
(203) 752-9291

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000031
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972581999
CT
Enumeration date
01/09/2006
Last updated
07/15/2016
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