LEESVILLE INTERNAL MEDICINE PA NPI 1205965217

NPI Information

NPI: 1205965217
Provider Name: LEESVILLE INTERNAL MEDICINE, PA
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
5816 CREEDMOOR RD
SUITE 105
RALEIGH, NC
ZIP 27612
Phone: (919) 881-0691
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LEESVILLE INTERNAL MEDICINE, PA is a primary care clinic center in Raleigh, NC. LEESVILLE INTERNAL MEDICINE, PA NPI is 1205965217. The provider is registered as an organization entity type.

The provider's business location address is:

5816 CREEDMOOR RD
SUITE 105
RALEIGH, NC
ZIP 27612-310
Phone: (919) 881-0691
Fax: (919) 881-0692

The provider's authorized official is Ahmad B Barakat .
The authorized official title is Owner and has the following contact phone number (919) 881-0691.

The enumeration date for this NPI number is 3/5/2007 and was last updated on 8/30/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	9701241	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	2345916	MEDICARE PIN	NORTH CAROLINA
2	5900610	MEDICAID	NORTH CAROLINA
3	G63300	MEDICARE UPIN	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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