Provider Demographics
NPI:1225167554
Name:HUFFMAN, LEILEI C (MD)
Entity Type:Individual
Prefix:DR
First Name:LEILEI
Middle Name:C
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LEILEI
Other - Middle Name:
Other - Last Name:CHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1460
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-1460
Mailing Address - Country:US
Mailing Address - Phone:540-659-2111
Mailing Address - Fax:540-659-1634
Practice Address - Street 1:95 DUNN DR
Practice Address - Street 2:123
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-1558
Practice Address - Country:US
Practice Address - Phone:540-659-2111
Practice Address - Fax:540-659-1634
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101247341207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1225167554Medicaid
VA540896390OtherCIGNA
VA6443946OtherAETNA HMO
VA9794669OtherAETNA PPO
VA6443946OtherAETNA HMO