Provider Demographics
NPI:1215043856
Name:SPICER, LEIGH M (MD)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:M
Last Name:SPICER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:201 SIGMA DR
Mailing Address - Street 2:STE 100
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7715
Mailing Address - Country:US
Mailing Address - Phone:843-856-6402
Mailing Address - Fax:843-216-5068
Practice Address - Street 1:899 ISLAND PARK DR
Practice Address - Street 2:STE. 200
Practice Address - City:DANIEL ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29492-8112
Practice Address - Country:US
Practice Address - Phone:843-856-6402
Practice Address - Fax:843-216-5068
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC26739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00384451OtherRR MEDICARE
SC267393Medicaid
SC267393Medicaid
SCI57288Medicare UPIN
SCAA14576868Medicare PIN