MEDICARE: CHARLES T LEEWOOD DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	036-115155	IL
2	207P00000X	Emergency Medicine Physician	1186	SC
3	207P00000X	Emergency Medicine Physician	061117	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306891395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES T LEEWOOD DO

Provider Business Mailing Address
First Line	:	5507 ABERCORN ST STE 103
Second Line	:	BOX 104
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6911
Country	:	US
Telephone Number	:	912-232-9700
Fax Number	:	912-232-9701

Provider Business Practice Location Address
First Line	:	5356 REYNOLDS ST
Second Line	:	201
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6016
Country	:	US
Telephone Number	:	912-819-8187
Fax Number	:	912-232-9701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	06/16/2026

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Directions to “ CHARLES T LEEWOOD DO” Practice Location

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