Leslie, Andrew C

Leslie, Andrew C is an individual health care provider with primary practice located at 8600 75Th St Suite 101, Kenosha WI 53142-8200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Leslie, Andrew C can be contacted via phone (262) 652-9430.

Contact Information

Primary practice address
8600 75Th St Suite 101 Kenosha WI 53142-8200
Phone: (262) 652-9430
Fax: (262) 658-9433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 32024 Wisconsin

Profile Details

NPI number 1689669954
LBN Legal business name Leslie, Andrew C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Apr 8th, 2011 - about 13 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 1689669954 NPPES
Wisconsin MEDICAID 31710200

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