Provider Demographics
NPI:1700841509
Name:LEDUC, ELIZABETH M (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:LEDUC
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:960 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 315
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1631
Mailing Address - Country:US
Mailing Address - Phone:404-389-1600
Mailing Address - Fax:404-389-1610
Practice Address - Street 1:960 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 315
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1631
Practice Address - Country:US
Practice Address - Phone:404-389-1600
Practice Address - Fax:404-389-1610
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2011-05-10
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Provider Licenses
StateLicense IDTaxonomies
GA034754208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
2277469002OtherCIGNA HEALTHCARE
785955OtherBLUE CROSS BLUE SHIELD