Provider Demographics
NPI:1437253788
Name:ESSIG, LEROY J (MD)
Entity Type:Individual
Prefix:
First Name:LEROY
Middle Name:J
Last Name:ESSIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 EXECUTIVE CENTER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3107
Mailing Address - Country:US
Mailing Address - Phone:540-371-1700
Mailing Address - Fax:540-371-1793
Practice Address - Street 1:240 EXECUTIVE CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3107
Practice Address - Country:US
Practice Address - Phone:540-371-1700
Practice Address - Fax:540-371-1793
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023868207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6066186Medicaid
VA025215OtherANTHEM BCBS
110011999OtherRAILROAD MEDICARE
110011999OtherRAILROAD MEDICARE
VA6066186Medicaid
VA00Y232M01Medicare PIN