Provider Demographics
NPI:1467435800
Name:LEINWEBER, CLINTON H (DO)
Entity Type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:H
Last Name:LEINWEBER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8423
Mailing Address - Street 2:NEWCO CANCER SERVICES
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:LEO JENKINS CANCER SERVICES
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-2900
Practice Address - Fax:252-744-3844
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007421E2085R0001X
NC2012-005952085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA300022290OtherRAILROAD MEDICARE
PA441411OtherBCBS PA
PA5541559002OtherCIGNA HMO
PA55526OtherGEISINGER HEALTH PLAN
NCP01619321OtherRR MEDICARE
NC1708WOtherBCBS
PA01207701OtherCAPITAL BC
PA0012439800006Medicaid
PA0136327000OtherKEYSTONE HEALTH PLAN EAST
NC5920688Medicaid
PA1030007OtherKEYSTONE MERCY
PA0441411OtherKEYSTONE HEALTHPLAN CENTR
PA1030007OtherAMERIHEALTH MERCY
PA111617OtherMEDPLUS/THREE RIVERS
PA1520775OtherGATEWAY
NC5541559OtherCIGNA
PA01207701OtherCAPITAL BC
PA300022290OtherRAILROAD MEDICARE
PA0441411OtherKEYSTONE HEALTHPLAN CENTR
PA1520775OtherGATEWAY
PA1030007OtherAMERIHEALTH MERCY