Provider Demographics
NPI:1659547818
Name:KASSIS, LEONARD KHALIL (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:KHALIL
Last Name:KASSIS
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 1:350 SUITE D FORTUNE TERRACE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-2972
Mailing Address - Country:US
Mailing Address - Phone:301-309-0016
Mailing Address - Fax:301-309-0174
Practice Address - Street 1:350 SUITE D FORTUNE TERR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2972
Practice Address - Country:US
Practice Address - Phone:301-309-0016
Practice Address - Fax:301-309-0174
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054434207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine