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NPI Code Detail

MEDICARE: DR. ROLANDO J. LEAL M.D.

MEDICARE: DR. ROLANDO J. LEAL 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
1207RG0100XGastroenterology PhysicianMD024629TN

General Provider Information

NPI Number : 1841272556
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROLANDO J. LEAL M.D.
Provider Business Mailing Address
First Line : 1324 WOLF PARK DR
Second Line : SUITE 38138
City : GERMANTOWN
State : TN
Zip : 38138-1741
Country : US
Telephone Number : 901-755-9110
Fax Number : 901-755-4321
Provider Business Practice Location Address
First Line : 1324 WOLF PARK DR
Second Line : SUITE 38138
City : GERMANTOWN
State : TN
Zip : 38138-1741
Country : US
Telephone Number : 901-755-9110
Fax Number : 901-755-4321
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 07/08/2007

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