Provider Demographics
NPI:1386602357
Name:SCHWAB, LESLIE E (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:E
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 BAKER AVE
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2129
Mailing Address - Country:US
Mailing Address - Phone:978-287-9350
Mailing Address - Fax:978-287-9356
Practice Address - Street 1:330 BAKER AVE
Practice Address - Street 2:INTERNAL MEDICINE
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2129
Practice Address - Country:US
Practice Address - Phone:978-287-9350
Practice Address - Fax:978-287-9356
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA43020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0016168OtherNEIGHBORHOOD HEALTH
MA3040402Medicaid
MAB10208202OtherCIGNA
MA4112076OtherAETNA
MA65065OtherHARVARD PILGRIM
MA714179OtherTUFTS
MAJ07884OtherBLUE CROSS
MA3040402Medicaid
MAB10208202OtherCIGNA