Provider Demographics
NPI:1366678922
Name:EILAND, LESLIE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:EILAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:ANNE
Other - Last Name:MAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:DEPT OF DIABETES ENDOCRINOLGY & METABOLISM
Mailing Address - Street 2:984120 NEBRASKA MEDICAL CENTER
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-4120
Mailing Address - Country:US
Mailing Address - Phone:402-559-6036
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF DIABETES ENDOCRINOLGY & METABOLISM
Practice Address - Street 2:984120 NEBRASKA MEDICAL CENTER
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-4120
Practice Address - Country:US
Practice Address - Phone:402-559-6036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA003938207R00000X
NE6649207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine