Provider Demographics
NPI:1366687378
Name:CLAPP, LESLIE ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ELLEN
Last Name:CLAPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:260 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4922
Mailing Address - Country:US
Mailing Address - Phone:919-488-0015
Mailing Address - Fax:919-277-0066
Practice Address - Street 1:4551 NEW BERN AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1551
Practice Address - Country:US
Practice Address - Phone:919-861-7793
Practice Address - Fax:919-488-1458
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2007--01253208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00965311Medicaid