Healthcare Provider Details

I. General information

NPI: 1255388310
Provider Name (Legal Business Name): LESLIE HOWARD POINSETTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 MEDICAL RIDGE DR
GREENVILLE SC
29605-4267
US

IV. Provider business mailing address

369 WOODRUFF RD
GREENVILLE SC
29607-3415
US

V. Phone/Fax

Practice location:
  • Phone: 864-271-7440
  • Fax: 864-271-6001
Mailing address:
  • Phone: 864-242-5872
  • Fax: 864-242-5640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number22780
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: