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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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