Healthcare Provider Details

I. General information

NPI: 1184651739
Provider Name (Legal Business Name): STEVEN I LEFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 PEACHTREE DUNWOODY RD STE 300
ATLANTA GA
30342
US

IV. Provider business mailing address

5505 PEACHTREE DUNWOODY RD NE STE 300
ATLANTA GA
30342-1705
US

V. Phone/Fax

Practice location:
  • Phone: 404-257-0814
  • Fax: 404-806-7567
Mailing address:
  • Phone: 404-257-0814
  • Fax: 404-806-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number028590
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: