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NPI Code Detail

MEDICARE: DR. LESLIE SIERRA RENTEN M.D.

MEDICARE: DR. LESLIE SIERRA RENTEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician34465NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205828324
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE SIERRA RENTEN M.D.
Provider Business Mailing Address
First Line : PO BOX 98146
Second Line :
City : RALEIGH
State : NC
Zip : 27624-8146
Country : US
Telephone Number : 919-420-7811
Fax Number : 919-420-7815
Provider Business Practice Location Address
First Line : 612 MOCKSVILLE AVE
Second Line :
City : SALISBURY
State : NC
Zip : 28144-2732
Country : US
Telephone Number : 704-210-5078
Fax Number : 704-210-5395
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 09/24/2007

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