Provider Demographics
NPI:1578622155
Name:ANITA L LEININGER MD PC
Entity Type:Organization
Organization Name:ANITA L LEININGER MD PC
Other - Org Name:NORTHWEST OHIO CENTER FOR BREAST CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:LUCIA
Authorized Official - Last Name:LEININGER
Authorized Official - Suffix:
Authorized Official - Credentials:MP
Authorized Official - Phone:419-893-5905
Mailing Address - Street 1:3375 CHARTER OAK DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537
Mailing Address - Country:US
Mailing Address - Phone:419-867-7455
Mailing Address - Fax:
Practice Address - Street 1:5901 MONCLOVA ROAD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537
Practice Address - Country:US
Practice Address - Phone:419-893-5905
Practice Address - Fax:419-897-8375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35080460208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty