Provider Demographics
NPI:1174813851
Name:RONALD, LEAH SCANLIN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:SCANLIN
Last Name:RONALD
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:DRESSLER
Other - Last Name:SCANLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 CAMBERWELL CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6038
Mailing Address - Country:US
Mailing Address - Phone:206-390-2318
Mailing Address - Fax:
Practice Address - Street 1:2900 N LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5640
Practice Address - Country:US
Practice Address - Phone:206-390-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC173151207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology