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General NPI Number Information
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NPI Number | 1104977701
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Entity Type | Organization
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Legal Business Name | THOMAS M LELAND MD PA
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 1483 TOBIAS GADSON BLVD SUITE 103
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City | CHARLESTON
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State | SC
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Zip | 29407-8702
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Country | US
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Telephone | 843-571-7337
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Fax | 843-571-6911
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Provider Business Mailing Address
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Address Line | 1483 TOBIAS GADSON BLVD SUITE 103
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City | CHARLESTON
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State | SC
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Zip | 29407-8702
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Country | US
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Telephone | 843-571-7337
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Fax | 843-571-6911
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS MIKELL LELAND
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Credential | MD
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Telephone | 843-571-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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