Provider Demographics
NPI:1609293943
Name:LEITWEIN, KATHRYN (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:LEITWEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8240 NAAB ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260
Mailing Address - Country:US
Mailing Address - Phone:317-207-7503
Mailing Address - Fax:317-338-2851
Practice Address - Street 1:8240 NAAB ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260
Practice Address - Country:US
Practice Address - Phone:317-207-7503
Practice Address - Fax:317-338-2851
Is Sole Proprietor?:No
Enumeration Date:2014-03-25
Last Update Date:2022-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01080757A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery