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General NPI Number Information
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NPI Number | 1538199641
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Entity Type | Individual
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Provider Name | LEANDRA M TONWEBER PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 8810 BLAKENEY PROFESSIONAL DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-6595
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Country | US
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Telephone | 704-910-1402
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Fax |
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Provider Business Mailing Address
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Address Line | 8810 BLAKENEY PROFESSIONAL DR
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City | CHARLOTTE
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State | NC
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Zip | 28277-6595
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Country | US
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Telephone | 704-910-1402
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 103600
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 103600
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License Number State | NC
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