Provider Demographics
NPI:1073932489
Name:CASSIDY, LESLIE ANNE V (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE ANNE
Middle Name:V
Last Name:CASSIDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:615 MICHAEL ST WHITEHEAD BIOMEDICAL RESEARCH BLDG
Mailing Address - Street 2:ROOM 247
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-712-2945
Mailing Address - Fax:
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-3033
Practice Address - Country:US
Practice Address - Phone:404-686-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2019-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7020207R00000X
GA83421207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine