Healthcare Provider Details

I. General information

NPI: 1083618540
Provider Name (Legal Business Name): RONALD PAUL LEEMHUIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2005
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 W 22ND ST
ERIE PA
16502-2614
US

IV. Provider business mailing address

4601 BASSWOOD DR
ERIE PA
16506-1553
US

V. Phone/Fax

Practice location:
  • Phone: 814-456-2003
  • Fax: 814-456-4098
Mailing address:
  • Phone: 814-456-2003
  • Fax: 814-456-4098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberMD022978E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD022978E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD022978E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: