Grissom, Leslie E.
Grissom, Leslie E. is an individual health care provider with primary practice located at 1600 Rockland Rd , Wilmington DE 19803-3607. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Radiology, which is considered as her primary health care specialty. Grissom, Leslie E. can be contacted via phone (302) 651-4000.Contact Information
Primary practice address
1600 Rockland Rd
Wilmington DE 19803-3607
Phone: (302) 651-4000
Fax: (302) 651-4945
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | C10002480 | Delaware |
Profile Details
| NPI number | 1225120108 |
|---|---|
| LBN Legal business name | Grissom, Leslie E. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2006 |
| Last updated | Feb 4th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225120108 | NPPES |
| California | MEDICAID | XPY196074 | |
| California | MEDICAID | 1165522 | |
| California | MEDICAID | 5166608 | |
| California | MEDICAID | 64195951 | |
| California | MEDICAID | 806321200 | |
| California | MEDICAID | 1437681 | |
| California | MEDICAID | 7709013 | |
| California | MEDICAID | 1197564 | |
| California | MEDICAID | 510123 |
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