Provider Demographics
NPI:1689823403
Name:PARTEM, LESLIE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:MARIE
Last Name:PARTEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESIA
Other - Middle Name:ISANISIA
Other - Last Name:PARTEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2 BALA PLZ
Mailing Address - Street 2:SUITE IL-27
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1501
Mailing Address - Country:US
Mailing Address - Phone:610-668-9999
Mailing Address - Fax:
Practice Address - Street 1:2 BALA PLZ
Practice Address - Street 2:SUITE IL-27
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-668-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD434548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine