Provider Demographics
NPI:1598788721
Name:HOLMES, LESLIE R (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:R
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SINAI HOSPITAL
Mailing Address - Street 2:2401 W. BELVEDERE AVE.
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215
Mailing Address - Country:US
Mailing Address - Phone:410-601-5689
Mailing Address - Fax:410-601-6307
Practice Address - Street 1:SINAI HOSPITAL
Practice Address - Street 2:2401 W. BELVEDERE AVE.
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215
Practice Address - Country:US
Practice Address - Phone:410-601-5689
Practice Address - Fax:410-601-6307
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0455002085R0001X
MDD886812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH39815001Medicare UPIN