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General NPI Number Information
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NPI Number | 1932794864
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Entity Type | Individual
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Provider Name | LEONARD GERFIELD DAVID CSFA
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Gender | Male
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 1398 PARKVIEW ESTATES DR
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City | ELLISVILLE
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State | MO
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Zip | 63021-4643
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Country | US
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Telephone | 314-629-4262
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Fax |
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Provider Business Mailing Address
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Address Line | 1398 PARKVIEW ESTATES DR
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City | ELLISVILLE
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State | MO
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Zip | 63021-4643
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Country | US
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Telephone | 314-629-4262
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 200837
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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